The purpose of the study was to prospectively evaluate the outcomes of phf fixation with a locking blade nail lbn or locking plate philos osteosynthesis in a. Short and long humeral nail medin proximal humeral nails. Locking nail versus locking plate for proximal humeral. Humeral nailing system stryker pdf catalogs technical. The retrograde nail length is determined by measuring the distance from 1cm above the olecranon fossa to the center of the humeral head. Proximal humeral fracture postsurgical rehabilitation protocol open reduction internal fixation general principles. Treatment of proximal humeral fractures with im nails. Retrograde humeral nail biomet retrograde reamedunreamed 21,22 russelltaylor humeral nail smith and nephew antegrade reamed 2328 t 2 stryker antegraderetrograde reamedunreamed uni. To complement the t2 nailing system, stryker trauma has created a new generation humeral implant. Solid humeral nail uhn and proximal humeral nail phn.
Pdf proximal humerus fractures are the third most common fracture in the elderly. Materials and methods between october 2004 and january 2007, 24 women and 4 men aged 38 to 87 mean, 65 years underwent intramedullary nailing for displaced proximal humeral fractures. The trigen humeral nail provides new possibilities for the treatment of proximal humeral fractures and humeral shaft fractures. Fractures were classified into 2part n8, 3part n17, and 4part n3, and corresponded. T2 proximal humeral nail intermedulary nail system t2 humeral nail intermedulary nail system. Therefore, the present study aimed, first, to present our experience with the stryker stryker uk ltd, newbury, uk t2. To complement the t2 nailing system, stryker osteosynthesis has created a humeral implant. Intramedullary nail for treating proximal humerus fractures. Anglestable intramedullary nailing of proximal humerus fractures with the phn proximal humeral nail. It can be used universally for either the left or right humerus. The expert humeral nail can be inserted into the humeral shaft in both antegrade and retrograde directions. This study showed that the proximal humeral nail and the rigid internal fixator are stronger than the semielastic locked plate and the synthes tplate for unstable subcapital proximal humeral. A humeral nail for the surgical care of fractures of the proximal humerus, with a shaft which has a longitudinal axis and is provided in a proximal portion with at least transverse bores spaced apart in the axial direction.
Intramedullary fixation of proximal humerus fractures. The entry point for the talon distalfix humeral nail is in line with the medullary canal in the lateral view. Conclusion we find this rotator interval approach safe and effective to cope with 2part humeral neck and humeral shaft fractures. Short humeral nails the short humeral nail enables osteosynthesis of armbone head. Attach the proximal drop 717511 to the lateral arm of the nail drill guide to complete the assembly. From a populationbased implant design, a patented screwtoplate interface, and streamlined instrumentation, our focus was on creating a welldesigned plating system, giving you more time to focus on other things.
Sirus zimmer and stryker t2 phn proximal humeral nail. Attach the impactor 717513 to the humeral nail guide bolt. It can be used universally for the left and right humeri. The new metal head is attached to a stem, which is inserted.
Displaced or unstable fractures require open reduction and internal fixation. The stryker t2 proximal humeral nail stryker, kalamazoo, mi, usa, for example, was designed to incor porate a number of features including a small diameter, left. Treatment of proximal humerus fractures with the stryker. Bony healing occurs usually within 6 to 8 weeks in adults 2. Uniflex humeral nail surgical technique zimmer biomet. We present a clinical prospective study evaluating this implant for proximal.
System, stryker osteosynthesis has created a humeral implant. Internal fixation of proximal humerus fractures using the. One implant, two approaches stryker trauma has created a new generation locking nail system, bringing. Internal fixation of proximal humeral fractures with a. Distal locking screws for the 18cm or longer humeral nails should be targeted using a freehand technique. The proximal end of the nail has two holes ml and two holes ap to accept up to four locking screws and it. Phn has been designed for antegrade insertion into the proximal humeral shaft. Short 150 mm and long 185320 mm, in 15 mm increments. Our objective was to investigate the clinical and radiographic results of the internal fixation using polarus humeral nails for fractures of the proximal humerus. This device shows promise for applications involving the reconstruction of the humeral shaft and head with minimal soft tissue stripping and for providing a locked, fixedangle construct for. Flexible intramedullary nailing for treatment of proximal. Fractures of the proximal humerus including 2part surgical neck fractures, 3part fractures and 4part fractures fractures of the proximal humerus with diaphyseal extension diaphyseal fractures of the humeral. One implant, two approaches stryker osteosynthesis has created a locking nail system, bringing together all the capabilities and benefits of separate antegrade and retrograde nailing.
The axis of the three bores are circumferentially offset in respect to each other in planes perpendicular to the longitudinal axis of the shaft. Consult strykers entire humeral nailing system catalogue on medicalexpo. Humeral shaft fractures and nailing approach there is still an ongoing discussion about the approach for humeral nailing 12, 19. Six different commercially available proximal humeral nails were implanted. Winkelstabile marknagelosteosynthese fur proximale.
T2 proximal humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. This involves removing the humeral head, and replacing it with a new metal head. Surgical management of proximal humerus fractures remains controversial and there is an increasing interest in intramedullary nailing. Proximal humeral fractures and intramedullary nailing. Operative time for humeral shaft fractures was significantly lower than for proximal humeral injuries p 0. Anglestable intramedullary nailing of proximal humerus fractures with the. Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a.
A new rotator interval approach for antegrade humeral. The t2 humeral nail offers multiple locking modes static, controlled dynamic and compression locking options to allow for ease of use and versatility in care. Mrs upper extremity surgical protocol mrs distal humerus the mrs distal humerus and ulna system is designed for a universal fit with the mrs proximal humerus system and solar ulna components. Although axillary nerve injury has been reported, no study has compared the safety of the proximal locking options relative to the axillary nerve and the ascending branch of the anterior circumflex artery. Intramedullary nailing for displaced proximal humeral. Clinical example using a, b, c, and e level screws 1 features anatomicallyshaped ten suture holes around the perimeter of the proximal end proximal locking holes accept 3. Proximal humerus fracture book twin cities orthopedics. Proximal humerus fractures are one of the most common fractures. Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a number of unique features. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological. There is little guidance on which patients are likely to do well with humeral nailing. Entry portal for a straight nail is 5 mm posterior to the. More variants of locking allow good fixation of short fragments and optimal reposition of the fractures. Phn in 61 displaced fractures of the proximal humerus and, second, to identify which groups of patients are likely to do.
Figure 1 a fixed humeral nail is locked proximally and. The t2 humeral nailing system is systems to offer an option for either an antegrade or a retrograde approach to repair fractures of the humerus. Nevertheless, modern humeral nail families include both a diaphyseal nail and a proximal nail expert humeral nail ehnao or t2 humeral nail stryker and others. Iuh methodist hospital orthopedic trauma service disclosures stryker trauma research and design consultant speaker board stock. Hydroset injectable ha bone substitute inion otps biodegradable plates, screws and pins. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological humeral fractures, and impending pathological fractures. Monoaxial locking plate system for treating proximal humerus fractures. Pdf intramedullary nailing of the proximal humerus. The goal of this study was to evaluate fracture healing and alignment as well as functional outcome and complication risks after internal fixation with the intramedullary proximal humeral nail phn. Proximal humeral fractures phfs are the third most common fracture in older patients. In either approach, the surgeon should consider the appositioncompression feature of the t2 humeral nail, knowing that 6mm of active apposition compression is possible, prior to deter. The t2 proximal humeral nail is intended to be used for various types of proximal andor diaphyseal fractures of the humerus. Treatment of proximal humerus fractures with the stryker t2. A proximal humerus fracture is a break in the arm bone near the shoulder, or a broken shoulder.
Treatment of proximal humerus fractures with the stryker t2 proximal humeral nail. Methods sixtyone consecutive patients with acute unilateral displaced proximal humerus fractures. Distal humeral component distal end accepts bearing insert, axle bushing and axle pin and provides an. To allow easy access to the proximal humerus, it is helpful and recommended to place the carm on the opposite side of the table of the injured limb. Return to normal function and motion may require 3 to 4 months overall goals. External rotation of the humeral head is then required to bring the entry point into the incision area. Proximal extension of the skin incision with resection of the cal may also be applicable in difficult cases.
The mean total operative time was 56 21103 min for the humeral shaft fractures, 67 39120 min for proximal humeral fractures and 71 341 min for proximal humeral physeal injuries. Humeral nail designs have undergone significant innovation during the past 40 years and now can provide stable. Intramedullary nail for proximal humerus fractures. The standardised proximal spiralblade locking ensures sufficient anchoring even in an osteoporotic humeral head. Increase rom while protecting the fracture site you can be slightly more. Tighten the humeral nail guide bolt using the guide bolt wrench 717514. Intramedullary nailing of humeral head and humeral shaft. Intramedullary locked nailing is becoming a popular alternative treatment, especially for easier fracture patterns. Modern proximal humeral nail designs and techniques assist the surgeon in adhering to these principles and have demonstrated promising outcomes. This publication sets forth detailed recommended procedures for using. Although most fractures can be treated conservatively with. Pdf anglestable intramedullary nailing of proximal humerus. Versanail humeral proximal nailing system 8 patient positioning position the patient supine in the beach chair position on a radiolucent table figure 1.