Ao surgery reference is a resource for the management of fractures, based on current clinical principles, practices and available evidence. 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. The application of indirect reduction techniques in the distal radius. Adult humeral shaft fractures are associated with primary radial nerve palsy in up to 18% of cases. Journal of college of physicians and surgeons pakistan. Surgical techniques in orthopaedics and traumatology. Operative techniques are a feature of our manual series and provide a stepbystep illustrated guide to the surgical procedures detailed in the related chapter. U04 fxs of humeral shaft free download as powerpoint presentation. Because of the limitations of current surgical techniques we adapted the. 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. Simple and complex fractures of the humerus a guide to. Both the oesophagus and stomach are larger and more distensible than the small intestine, so foreign bodies are more likely to become lodged in the small intestine, particularly the duodenum and jejunum. Surgical procedure for intraarticular and scapular neck fractures humerus 55.
Marchetti vicenzi elastic retrograde nail in the treatment of humeral shaft fractures. Reverse shoulder arthroplasty for acute proximal humerus fractures. Modern proximal humeral nail designs and techniques assist the surgeon in adhering to these principles and. Once again we stress that none of the articles substitutes for aos surgical techniques or teaching tools. The surgical approach for the straight antegrade intramedullary nail sain was either the. All implantation procedures were performed by the same orthopaedic surgeon who has more than 8 years of experience in shoulder and elbow surgery. The success of intramedullary nailing techniques for lower limb fractures in the 1980s provoked an interest in the use of this technique for humeral fractures. Original article, report by chinese medical journal. Types of fractures include, but are not limited to, nonunions, malunions, malalignments, pathological fractures, and impending pathological fractures. Percutaneous im nailing of 2part surgical neck fractures. Stepbystep format provides clear guidance for performing procedures the userfriendly layout features text on the left side of each. Many different nails are available in market with different proximal and distal locking configurations. This chapter includes details of a primary and secondary repair of nerves. The surgical approach for the straight antegrade intramedullary nail sain was either the anterolateral.
The affixus natural nail humeral system is a long bone nailing system that is built on the natural nail and affixus intramedullary platforms. Musculoskeletal surgery, volume 99, issue 3 springer. Complications after interlocking intramedullary nailing of humeral shaft fractures. Ao principles of fracture management apivatthakakul. Nonsurgical management of humeral shaft fractures with functional bracing gained popularity in the 1970s, and this method is. Beach chair and supine are the main principle positions for. The role of nailing as opposed to plating of humeral fractures is the subject of continuous debate. Proximal humerus fracture book twin cities orthopedics.
Minimally invasive plate osteosynthesis mipo in long bone fractures biomechanics design clinical results. Current techniques for surgical management of these fractures are extremely effective in alleviating pain and allowing patients to resume an ambulatory status, often without the need of external support. Indications for different forms of treatment, including nonsurgical, are presented in detail, and all of the commonly used fixation techniques are described with the help of highquality illustrations. Surgical procedure for fracture of the lateral portion of the humeral condyle 57. The metal threads on the proximal locking holes should always be lateral. Norberg rarely uses this technique, however it is appropriate for certain patients. Other relative indications included softtissue compromise. Complications after interlocking intramedullary nailing of. The nail and nail drill guide are keyed to ensure proper orientation of the nail on the nail drill guide figure. This volume clearly explains the concepts that are central to an understanding of humeral fractures from the proximal to the distal tip. This involves removing the humeral head, and replacing it with a new metal head. Most humeral shaft fractures unite if left alone in the same room.
Although nonoperative treatment techniques are addressed and can be used in less severe circumstances, this book focuses mainly on the current operative treatment techniques for proximal humerus and tuberosity fractures, malunions and nonunions. Proximal humerus fracture book frank norberg, md eden prairie clinic 12982 valley view road. This book covers every aspect of humeral fractures from the proximal to the distal tip, including surgical and nonsurgical treatment, rehabilitation and more. The multiloc humeral nail long includes easily identi. A variety of treatment options for humeral shaft fractures have been studied and described including closed means, such as functional bracing, and open techniques with internal fixation.
Download for offline reading, highlight, bookmark or take notes while you read proximal humerus fractures. Tighten the humeral nail guide bolt using the guide bolt wrench. The reported advantages included minimal surgical invasion, avoidance of the fracture exposure, preservation of the vasculature, and reduced risk of infection. Long kirschner wires of 2010 diameter were used as flexible nails for a. Many patients choose open reduction and internal fixation. Whether youve loved the book or not, if you give your honest and detailed thoughts then people will find new books that are right for them.
This has led to the application of surgical techniques. The treatment of humeral fractures is a complex issue and the source of considerable controversy. Multiplanar distal locking reduces implant toggling in proximal humeral nailing. The advent of surgical amputation and its difficulties form a major part of the book, summarising the evolution of the control of haemorrhage and infection, pain relief, techniques, instrumentation, complications, prostheses, results and case histories. The nail and nail drill guide are keyed to ensure proper orientation of the nail on the nail drill guide figure 12. Fracture union in closed interlocking nail in humeral. This surgical technique was developed to capitalize on the advantages of the traditional percutaneous pinning technique eg, temporary fixation, preservation of the soft tissues, and better cosmesis and to improve its limitations. Surgical procedure for stabilizing a comminuted diaphyseal fracture with an interlocking nail 48. Minimally invasive plate osteosynthesis mipo in long.
The surgical procedures were performed by 4 different senior surgeons. Humeral nail guide bolt 71751108 to attach the nail drill guide 71751129 to the nail. Humeral shaft fractures account for approximately 3% of all fractures. It illustrates the use and relevance of this technique in orthopaedic and trauma surgery including reconstructive surgery, covering the basic scientific principles of reaming and locking as well as basic and advanced surgical techniques. Alternative procedures, increasingly important in the last two centuries, are also debated.
Interlocking intramedullary nailing for nonunion of the proximal humerus with the straight nail system. These numbered holes correlate to the number identifiers listed. Humeral nail guide bolt to attach the nail drill guide to the nail. Place the carm opposite the surgeon, perpendicular to the longitudinal axis of the humeral shaft in the ap view. Proximal humerus fractures evaluation and management lynn. This, in turn, has significantly improved the quality of. Another surgical treatment option is a closed reduction with intramedullary nailing. This video demonstrates the technique for intramedullary nailing of a humeral shaft fracture. Surgical landmarks to determine humeral head retrotorsion for hemiarthroplasty in fractures. Locking intramedullary nails and locking plates in the treatment of twopart proximal humeral surgical neck fractures. Position the carm to allow visualization of the entire humerus in the ap and lateral planes. Revision total hip arthroplasty for fractured ceramic bearings. Biomechanical comparison of humeral nails with different distal. Surgical approach of open reduction and internal fixation.
Health, general care and treatment research fractures injuries. The incidence of proximal humeral fracture is increasing gradually. Humeral nailing was indicated given the comminuted nature of the diaphysis and to allow for minimal skin incisions. Antegrade and retrograde nail insertion are equally popular. The surgical approach for the straight antegrade intramedullary nail sain was either the anterolateral deltasplit group 2, n 79 or the portal of neviaser group 3, n 27. In proximal humeral fracture except ao classification 11a1, fixations with a locking plate and nails are recommended. Another option for surgical treatment is a hemiarthroplasty. Other readers will always be interested in your opinion of the books youve read. The objective of this retrospective nonrandomized study was to evaluate the portal of neviaser pn as an alternative approach in antegrade humeral nailing. It features the latest techniques for arthrotomy, joint stabilization, arthrodesis, fracture repair, corrective osteotomies, and limb amputation. Jcm free fulltext fractures of the humeral shaft with. Atlas of orthopedic surgical procedures of the dog and cat.
Multiloc humeral nailing system surgical technique depuy synthes 3. Kapandji technique for proximal humerus fractures lebanese medical journal 2016 vol 64 3 169. The purpose of this study was to assess the influence of injury mechanism, fracture type, and treatment on nerve recovery in patients with humeral shaft fractures and primary nerve palsy. The management of nerve defects is discussed and techniques for nerve grafting are.
Antegrade intramedullary nailing for the treatment of. This chapter covers anatomy, diagnostic and surgical. Orthopedic surgical management of skeletal complications. By paul dan sirbu, tudor petreus, razvan asaftei, grigore berea and paul botez. Surgical procedure for transverse scapular body fractures 53. Although nonoperative treatment techniques are addressed and can be used in less severe circumstances, this book focuses mainly on the current operative treatment techniques for proximal humerus and tuberosity fractures, malunions and. This procedure involves reduction under xray in the operating room, and. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complications and fast postoperative recovery. Fracture union in closed interlocking nail in humeral shaft fractures. Book awards book club selections books by author books by series coming soon kids books new releases teens books this months biggest new releases. Intramedullary fixation of humeral shaft fractures using.
Risk assessment of retrograde intramedullary nailing for. At least 20 publication records of articles and or books related to. R rambani, d kepecs, t makinen, o safir, a gross, p kuzyk. With the advent of good designs of nails, straight and angled in the arena of treatment for fractures from surgical neck of humerus to approximately 5 cm above the olecranon fossa, nailing is gaining popularity in recent literature. This atlas vividly illustrates stepbystep procedures for common orthopedic techniques used to treat small animals. There are three main surgical techniques to treat humeral shaft fractures. Surgical procedure for proximal humeral physeal fractures 56. The multiloc humeral nail and the philos depuy synthes companies. The patient shown in the video is a 30yearold man who sustained a gunshot wound to his right arm. Surgical interventions to treat humerus shaft fractures. Humerus nailing in lateral position operative technique.
Results of nonunion of humerus treated with retrograde humeral nail. Between 1997 and 2005, 99 acute fractures of the humeral shaft were treated operatively with the unreamed humeral nail uhn, synthes in. Surgical procedure for supraglenoid tuberosity fractures 54. Houlocked nail treatment of humeral surgical neck nonunions. Exploration and repair of nerves requires specialized equipment, detailed anatomical knowledge, and expertise in microsurgery. This system offers a complete portfolio of implants and instruments, which treats a wide range of humeral fractures using simple and efficient instrumentation.
Tighten the humeral nail guide bolt using the guide bolt wrench 717514. Prevention of complications and complication management are discussed in detail. I seriously believe if this text and kuntschers military book had been available to my. Pediatric orthopaedic surgerya title in the operative techniques seriesoffers you the stepbystep guidance you needon femoral lengthening, sofield procedure, distal radius fracture, and morefrom experts mininder kocher and michael b. Our manuals series includes some 300 operative technique sections and this page provides an az listing of all the manual chapters that contain them. The aequalis humeral nail system is intended to provide temporary stabilization of various types of proximal andor diaphyseal fractures of the humerus. The objective of this prospective observational study is to compare plate versus nail fixation of two,three and four part proximal humeral fractures regarding surgical time for intraoperative fluoroscopy, functional, functional assessment using neers score and radiological assessment of quality of reduction, presence of hard warerelated.
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