A new approach for the treatment of proximal humeral. The objective of this work was to design the devices and methods necessary for a computerassisted distal locking technique for intramedullary nailing of the femur using an electromagnetic tracking system. Pdf intramedullary nailing of humeral shaft fractures. The american shoulder and elbow surgeons ases scores and a 10 cm. In three and four part fractures, the humeral operative technique. Both antegrade femoral nails are designed to accommodate a standard femoral locking mode or the recon locking mode in the same leg. The surgical technique consisted of a synthesis with an anterograde. Fda food and drug administration, united states of america. Evaluation of a computerassisted technique for distal.
There are clearly patients who benefit significantly from proximal humeral nailing for displaced traumatic fractures, but uniform surgical indications are yet to be defined. Surgical technique for the trigen humeral nail system. Cpt description revenue code charge wilson charge code. Uniflex humeral nail surgical technique zimmer biomet. Orthofix is the latest company to withdraw 2020 revenue guidance and announce tactics to continue forward movement during the covid19 era. Check the reduction and read off the nail length from the image of the ruler.
There is a wide variety of surgical techniques and implants to treat these fractures, but there is little. Box 5000, fin90014 university of oulu, finland 2004 oulu, finland abstract although nonoperative treatment is recognized as an effective treatment method for humeral shaft. The trigen humeral nail provides new possibilities for the treatment of proximal humeral fractures and humeral shaft fractures. 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. These instrumentation, systems, and processes are accomplished by using a computer to intraoperatively obtain.
Modern proximal humeral nail designs and techniques assist the surgeon in adhering to these principles and. Issuu is a digital publishing platform that makes it simple to publish magazines, catalogs, newspapers, books, and more online. Including surgical devices and advanced wound care products. The longterm goal of this work is to increase the efficiency and decrease the radiation exposure to the surgical team during the intramedullary nailing procedure. Intramedullary locked nailing is becoming a popular alternative treatment, especially for easier fracture patterns. The screw misplacement is a wellknown complication of fluoroscopicguided ils. Treatment of pathological humeral shaft fractures with.
A callus is classified into a central callus occupying the exact volume of the fracture gap and converting into bones after the completion of the fracture healing process and an external callus that covers the fracture site in an oval shape form and is absorbed in the body after the completion of the fracture healing process, as shown in fig. A new approach for the treatment of proximal humeral fractures using the trigen proximal humeral nail. Mobilization of the patients started on the 2nd postoperative day. An external file that holds a picture, illustration, etc. Distal humeral fracture fixation with an extensor mechanismon approach jason m.
Trigen humeral intramedullary nail bmt medical devices. With multiplanar screws that are threaded into the nail and designed to inhibit proximal screw backout, and effective, simple instrumentation designed to help protect soft tissues, the trigen humeral nail system offers. Humeral shaft fractures 2 surgical techniques ota lecture. The solid humeral nail uhn can be used for an antegrade or retrograde insertion in the humeral shaft, and can be employed universally for the left and right humeri. Measure the length of the unfractured humerus from its head to the olecranon fossa and deduct 56 cm from the measured distance. Trigen intertan intramedullary nail versus sliding hip. Efficacy comparison of intramedullary nails, locking plates and. However, in general, the unique anatomy and biomechanical characteristics of the humerus and its adjacent joints were overlooked. Surgical stabilization of humeral shaft fractures in children, when indicated, can be safely performed using titanium elastic nails. With multiplanar screws that are threaded into the nail to inhibit proximal screw backout, and effective, simple instrumentation that helps protect soft tissues, the trigen system now offers an effective. May 21, 20 the mean neckshaft angle 1 year after surgery was 125 8. The trigen humeral nailing system product offering includes a 16cm proximal straight nail, a 16cm proximal bent nail, and a full line of long bent nails.
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. Instrumentation, systems, and processes for tracking anatomy, instrumentation, trial implants, implants, and references, and rendering images and data related to them in connection with surgical operations, for example total knee arthroplasties tka. Pm005 the problems of early surgical treatment of periprosthetic humeral fractures h. Uncover an easy and advanced nailing system the trigen humeral nail provides new possibilities for the treatment of proximal humeral fractures and humeral shaft fractures. Diaphyseal humeral fractures and intramedullary nailing. Pm006 surgical versus nonsurgical treatment for humeral shaft fractures in adults. Residual interfragmentary gap after intramedullary nailing of fragility. The humeral sutureplate is an anatomically designed polyaxial locking plate and screw system designed for the treatment of proximal humeral fractures. Health canada health canada, canada date of issue yyyymmd description of product source of information reference no. Pdf intramedullary nailing of the proximal humerus. Jointpreserving palliative surgery using selflocking screws of. Surgical technique for the trigen humeral nail system using the.
Provisional fixation with the kwire placed along the anterior aspect of the humeral shaft into the humeral head can be done. Determine nail length the approximate nail length can be determined pre operatively. These low profile plates with polyaxial bushings provide freedom to direct the locking screws within the anatomical template, based on the fracture pattern and bone quality for better fixation. 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. Flinkkila, tapio, intramedullary nailing of humeral shaft fractures division of orthopaedic and trauma surgery, department of surgery, university of oulu, p. Instrumentation, systems, and processes for tracking anatomy, implements, instrumentation, trial implants, implant components and virtual constructs or references, and rendering images and data related to them in connection with orthopedic, surgical and other operations, for example total knee arthroplasty tka. With eleven convenient locations in the metro area, we are able to serve the northern va and dc region. Develops, manufactures and markets specialty surgical and medical products internationally, and provides outpatient physical therapy services in the united states. All pdf files and may take some time to load be patient. Trigen meta nail tibia trigen meta nail femur trigen knee nail retrograde femoral technique 3. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. The t2 proximal humeral nail is intended to be used for various types of proximal andor diaphyseal fractures of the humerus. Note as template magnification levels are set at 117%, all measurements are estimates of true size.
Furthermore, the development of the t2 humeral nailing system offers the competitive advantages of. The titanium flexible humeral nail system technique guide for antegrade or retrograde insertion synthes on. In response to the spread of the covid19 pandemic, sibone, stryker and vericel announced updates to their fullyear guidance. Small diameter intramedullary implant that requires only a 10mm.
Trigen humeral nail proximal and long trigen hindfoot nail. The trigen metanail retrograde femoral nail is indicated for fractures of the femur including stable and unstable distal metaphyseal fractures, diaphyseal fractures, intraarticular fractures, periprosthetic fractures, nonunions, malunions and for the prophylactic nailing of impending pathological fractures. The trigen humeral nail system is indicated for proximal andor diaphyseal fractures of the humerus, nonunions, malalignments, pathological humeral fractures. The trigen humeral nail with its versatile screw configuration was shown in a cadaver study to be one of the safest humeral nails for avoiding axillary nerve damage3 the trigen humeral nail system with sureshot technology is designed to distal lock the nail first, using the electromagnetic wand and perfect circles method for fewer. Mhra medicines and healthcare products regulatory agency, united kingdom. The uniflex humeral nail system was developed in conjunction with ralph b. The trigen intramedullary nail system, introduced in 1998 as an outgrowth of the. Trigen intertan intramedullary nail versus sliding hip screw a prospective, randomized multicenter study on pain, function, and complications in 684 patients with an intertrochanteric or. The file contains 142 pages and is free to view, download or print. Biomet, as the manufacturer of this device, does not practice medicine and. Xrays xrays should include knee and ankle on the same film to measure the nail. Nail size, screw length and femoral neck angle may be determined. Intramedullary fixation of proximal humerus fractures. Nails with a proximal bend are best suited for simple twopart fractures of the proximal humerus involving the surgical neck of the humerus and proximal third humeral fractures without.
Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. For fractures of the proximal humerus with diaphyseal extension and combined fractures of the proximal humerus and the humeral diaphysis, the three lateral screws greater. T2 proximal humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. Patients were treated with anterograde locked intramedullary nailing. As a result of the friendship and collaboration with ganz, these 2 surgeons became the top 2 contemporary hip preservation and reconstructive surgeons in the world. Biomechanical simulation of healing process of fractured. In 21 patients closed surgical technique and in 10 miniopen reduction was performed. Newer generation proximal humeral nail design and technique adhere to these principles and may lead to improved outcomes in the treatment of these problematic fractures. The titanium flexible humeral nail system technique guide for. Cpt description revenue code charge wilson charge code 5 fine needle bx w image guide 0361 2017. Solid humeral nail uhn and proximal humeral nail phn. Modern proximal humeral nail designs and techniques assist the surgeon in adhering to these principles and have demonstrated promising. Secondary complications were minimal and observed in only 6 of 54 patients.
A deltopectoral approach was used to expose fracture site in the plate group. If using the sureshot distal targeting system, be sure to read and understand the trigen sureshot distal targeting system user manual ref 71181540. Trigen meta nail tibial nail system surgical technique. In the proximal humerus, surgical treatment for bone metastasis was performed mainly in patients. Versanail humeral proximal nailing system zimmer biomet. Trigen humeral nail surgical technique pdf writer telegraph. Surgical treatment of traumatic pediatric humeral diaphyseal. In conclusion, the trigen intramedullary humeral nail is effective for the treatment of proximal humeral fractures. This brochure presents a surgical technique available for use with the biomet, inc.
The length can only be determined correctly on the. Proximal humerus fractures are one of the most common fractures. Orthopaedic division 1450 east brooks road memphis, tn 3 8 1 16 901 3995153 name of device. Alliance physical therapy free ebook download as pdf file. The surgical simulator showed that the entry point of the guidewire was anterior to the best entry point when a simulation was done.
The trigen hfn features an oblique locking configuration that allows surgeons to maximize thread purchase by locking into better bone. Examples of specific indications according to ao classification include type afractures, dislo. Step 1 for im nails with an end cap, begin by removing the end cap using instrumentation and direction from the winquist iii im nail removal system and surgical technique guide. Introduction open treatment of extraarticular and intraarticular distal humeral the fractures can be effectively accom. Surgical technique for the trigen humeral nail system using the trigen sureshot distal targeting system table of contents. The simulation of the technique by the use of the miss could have prevent the misplacement of screws in the s1 pedicle. 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. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological humeral fractures, and impending pathological fractures. This brochure is presented to demonstrate the surgical technique utilized by ralph b. The novel design of the aequalis im locking nail combines unique features that allow a less invasive surgical intervention, sustain the vascularization of the fracture fragments, angular stability of proximal fixation, and optimal screw orientation for fixation of the tuberosities. Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a number of unique features. Exposure and nail insertion were performed using the surgical technique recommended by each nail manufacturer, using fluoroscopy in order to. Surgeons may need to make modifications as appropriate in their own surgical technique with these devices depending on individual patient requirements. Pdf treatment of pathological humeral shaft fractures.
Feb 06, 2016 narrated, annotated lecture 2 of 3 on humeral shaft fractures from the ota resident lecture series narrated by saqib rehman, md, from. Request pdf the difficult proximal humerus fracture. Surgical technique uhnphn humeral nailing system depuy synthes 7 2. Intramedullary locking nail fixation of proximal humerus. In addition to withdrawing 2020 guidance, sibone has required all nonmanufacturing employees to work from home. The surgical technique is straightforward and is familiar to most pediatric orthopedists due to its widespread use in the treatment of other fractures in children 18, 2127. Computer assisted knee arthroplasty instrumentation. Surgical technique implant selection the trigen intertan nail preoperative template set 71674200 may be used to assist with preoperative implant selection. The humeral nail system can be used with or without the sureshot distal targeting system. Violation of the rotator cuff during antegrade humeral nailing has been considered to be responsible for suboptimal clinical outcomes and discomfort in the shoulder joint. The combination of minimally invasive surgical techniques with biomechanical. Utilizing the same trigen instruments, the tan was developed to simplify the surgical approach by allowing placement of the nail through the greater trochanter instead of the piriformis fossa. Optilock proximal humeral plating system surgical technique. The t2 proximal humeral nail is intended for single use only.
Distal humerus olecranon volar distal radius proximal humerus. The trigen humeral intramedullary nail brings the simplified instrumentation of the trigen nail system to the hindfoot. Smith and nephew, usa was inserted according to the usual proximal humeral im nail method. Versanail proximal humeral nailing system depuy orthopaedics. The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon. Humeral nailing, essentially thought to be relegated to pathologic fractures, has. In both surgical approaches, the special hole geometry of the nail ensures an optimal position of the locking holes.
At alliance physical therapy we provide 247 access to online appointments, with most of the requests scheduled in less than 48 hours. A consecutive series of 22 pathological fractures of the humeral shaft in 21 patients treated at one institution were included in this retrospective study. Russelltaylor deltatibial interlocking nail technique 598 kb recon interlocking. Distal humeral fracture fixation with an extensor mechanism.
The titanium flexible humeral nail system technique guide for antegrade or retrograde insertion. Following a metaanalysis of published literature, the trigen intertan allows patients to experience. Distal locking screws for trigen proximal 16cm humeral nails 31. Surgeon preparation read the technique manual and or watch the technique cd.
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