Therefore we present our study evaluating the stryker t2 proximal humeral nail t2. Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a. Entry portal for a straight nail is 5 mm posterior to the. Despite being a common orthopedic injury, the optimal management of proximal humeral fractures remains a topic of debate. The entry point for the talon distalfix humeral nail is in line with the medullary canal in the lateral view. Therefore we present our study evaluating the stryker t2 proximal humeral nail. Intramedullary nailing of humeral head and humeral shaft. Humeral nailing system stryker pdf catalogs technical. External rotation of the humeral head is then required to bring the entry point into the incision area. Pdf intramedullary nailing of humeral shaft fractures. Short and long humeral nail medin proximal humeral nails.
Intramedullary fixation of proximal humerus fractures. The stryker t2 nail is fixed with use of one to four proximal. Phn has been designed for antegrade insertion into the proximal humeral shaft. 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. Optilock upper extremity plating system proximal humeral. The uniflex humeral nail system can be used to manage fractures from the surgical neck of the humerus to a point approximately 6cm above the end of the medullary canal. Proximal humerus fractures are the third most common fracture in the elderly. T2 proximal humeral nail, t2 supracondylar nail, t2 recon nail, the indications have extended from shaft fractures to fractures of the metaphyseal regions. The t2 proximal humeral nail is intended to be used for various types of proximal andor diaphyseal fractures of the humerus.
The standardised proximal spiralblade locking ensures sufficient anchoring even in an osteoporotic humeral head. The retrograde nail length is determined by measuring the distance from 1cm above the olecranon fossa to the center of the humeral head. 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. Humeral shaft fractures and nailing approach there is still an ongoing discussion about the approach for humeral nailing 12, 19. 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. Aequalis im nail design tuberositybased screw pattern lags fragments perpendicular to the pull of the muscles screw pattern supports periphery of humeral head fragment and avoids the articular surface. System, stryker trauma has created a new generation humeral implant. To complement the t2 nailing system, stryker osteosynthesis has created a humeral implant. Solid humeral nail uhn and proximal humeral nail phn. Although most fractures can be treated conservatively with. Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a number of unique features. The expert humeral nail can be inserted into the humeral shaft in both antegrade and retrograde directions. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological humeral fractures, and impending pathological fractures.
Iuh methodist hospital orthopedic trauma service disclosures stryker trauma research and design consultant speaker board stock. Intramedullary nail for proximal humerus fractures. Short humeral nails the short humeral nail enables osteosynthesis of armbone head. Displaced or unstable fractures require open reduction and internal fixation. Intramedullary nail for treating proximal humerus fractures. The axis of the three bores are circumferentially offset in respect to each other in planes perpendicular to the longitudinal axis of the shaft.
A proximal humerus fracture is a break in the arm bone near the shoulder, or a broken shoulder. The reunion rfx system, when used with reunion tsa humeral and glenoid components, is indicated for use as a hemi or total shoulder replacement. To complement the t2 nailing system, stryker trauma has created a new generation humeral implant. More variants of locking allow good fixation of short fragments and optimal reposition of the fractures. More variants of locking allow good fixation of short fragments and. 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. The proximal end of the nail has two holes ml and two holes ap to accept up to four locking screws and it. It can be used universally for the left and right humeri. The stryker t2 proximal humeral nail stryker, kalamazoo, mi, usa, for example, was designed to incorporate a number of features including a small diameter, left and right versions, end caps of different heights, and threaded proximal locking holes with a nylon bushing for improved holding strength. Intramedullary nailing for displaced proximal humeral fractures. The surgical incision was performed from the outer side of the acromion, along the lateral aspect of the arm, passing through the deltoid muscle and rotator cuff.
Unreamed humeral nail uhn synthes antegraderetrograde unreamed 2,3,911,30,31 figure 1 a. A new rotator interval approach for antegrade humeral nailing. The two designs featuring such a bend and oblique bolt showed a mean distance of the locking screw to the axillary nerve of 1 mm and 2. Open and closed fracture patterns humeral shaft fractures fractures of the proximal and distal metaphysis.
United states court of appeals for the federal circuit. This publication sets forth detailed recommended procedures for using. 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 shaft impending pathological fractures 094228180628. There is little guidance on which patients are likely to do well with humeral nailing. Multiplanar fixation may help to restore the proper anatomic alignment of the humerus through a percutaneous approach. System, stryker osteosynthesis has created a humeral implant. T2 proximal humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. Humeral nail designs have undergone significant innovation during the past 40 years and now can provide stable fixation in the humeral shaft distally as well. Aug 18, 2015 short humeral nails the short humeral nail enables osteosynthesis of armbone head.
Outcomes of intramedullary nailing for acute proximal. The acumed polarus plus humeral rod is designed to provide fixation for 2, 3, and some 4 part fractures of the proximal humerus through a minimallyinvasive surgical procedure. Proximal extension of the skin incision with resection of the cal may also be applicable in difficult cases. This plate addresses complex fractures of the proximal humerus. Although based on the wellknown t2 platform, the t2 proximal humeral nail design incorporates a number of. Retrograde humeral nail biomet retrograde reamedunreamed 21,22 russelltaylor humeral nail smith and nephew antegrade reamed 2328 t 2 stryker antegraderetrograde reamedunreamed uni. The t2 proximal humeral nail is designed to be inserted either through a lateral a or a central b entry point fig.
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. Flexible intramedullary nailing for treatment of proximal humeral and humeral shaft fractures in children. It enables static or dynamic locking of 4 multidirectional proximal locking screws and 2 distal locking screws. Recovering from shoulder replacement surgery stryker. Use the awl or cannulated entry reamer to open the humeral head. Bony healing occurs usually within 6 to 8 weeks in adults 2. 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 comminution. Return to normal function and motion may require 3 to 4 months overall goals. The proximal humeral nail phn has been designed for antegrade insertion into the proximal humeral shaft. Background surgical treatment of displaced proximal humerus fractures remains controversial.
Treatment of proximal humerus fractures with the stryker. The nail was secured with two proximal locking screws and a distal screw. Comparison of plate, nail and external fixation in the. Locking nail versus locking plate for proximal humeral. Conclusion we find this rotator interval approach safe and effective to cope with 2part humeral neck and humeral shaft fractures. This is when the proximal humerus is fractured, and the joint surface of the ball humeral head and socket glenoid are out of their normal alignment. Pdf proximal humerus fractures are the third most common fracture in the elderly. Painful, disabling joint disease of the shoulder resulting from. Intramedullary nail for treating humeral shaft fractures.
Surgical technique and early outcomes of intramedullary nailing of. 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. It can be used universally for either the left or right humerus. Intramedullary nailing for displaced proximal humeral. In april 2004, acumed sued stryker for infringement of united states patent no. Internal fixation of proximal humeral fractures with a. Increase rom while protecting the fracture site you can be slightly more.
Pdf intramedullary nailing imn is an accepted technique for the treatment of humeral shaft fractures. In the ap view, the 4 lateral bend of the proximal nail pushes the entry point slightly lateral towards the greater tubercle fig. Intramedullary nailing of acute two and threepart proximal humerus fractures yields satisfactory clinical and functional results. The distal end of the nail accepts two crosslocking screws, and both should be used whenever pos. Stryker t2 proximal humeral nailing system surgical technique b009 acumed polarus 3 nail titanium alloy, ti6al4v 140 mm320 mm nail lengths 150 mm280 mm nail lengths 7 mm9 mm diameters available proximal nail 10 mm5. T2 humeral conical extraction rod 8 extraction of nails using proximal nail end. Humeral nailex universal design for the left or right humerus material titanium6% aluminum7% niobium alloy diameters 7. Consult strykers entire humeral nailing system catalogue on medicalexpo. Types of fractures include, but not limited to fractures of the humeral shaft, nonunions, malalignments, pathological. Manca, md short proximal humeral nail long proximal humeral nail removal of the handle and closure diaphyseal humeral nail. A varus proximal humeral deformity and lateral starting point allowed for avoidance of the rotator cu. Versanail humeral proximal nailing system 3 intramedullary fixation of humeral proximal fractures the versanail humeral proximal nail is part of a long bone nailing system that offers a complete portfolio of implants and instruments based on a single, standardized technology platform. Features and benefits proximal locking locking screws indications.
Distal humeral component distal end accepts bearing insert, axle bushing and axle pin and provides an. Flexible intramedullary nailing for treatment of proximal. Our objective was to investigate the clinical and radiographic results of the internal fixation using polarus humeral nails for fractures of the proximal humerus. It offers guidance that you should heed, but, as with any such technical. Modern proximal humeral nail designs and techniques assist the surgeon in adhering to these principles and have demonstrated promising outcomes. Treatment of proximal humeral fractures with im nails. Proximal humeral fractures phfs are the third most common fracture in older patients. The t2 proximal humeral nail stryker is made of titanium alloy and has a maximum diameter of 10 mm. Download pdf proximal numerus fracture plate, nail or replace. The 444 patent is directed to an intermedullary nail for fixing fractures of the proximal humeral cortex. Pdf intramedullary nailing of the proximal humerus. Treatment of proximal humerus fractures with the stryker t2. The t2 humeral nail is intended to provide temporary stabilization of various types of fractures, malunions and nonunions of the humerus. The proximal locking holes are threaded and have nylon bushings to enhance.
The humeral nail system can be used with or without the sureshot distal targeting system. Proximal bend 15 titanium nail and locking screws allows mri investigation, if necessary 10 mm proximal diameter 79 mm distal diameter one design for left and right humerus proximal bend 15 proximal humeral nail diaphyseal humeral nail 79 mm 5. Distal locking screws for the 18cm or longer humeral nails should be targeted using a freehand technique. Although most fractures can be treated conservatively with acceptable outcomes, certain fracture patterns are at high risk for progression to humeral malunions, nonunions, stiffness, and posttraumatic arthrosis. 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. Uniflex humeral nail surgical technique zimmer biomet. Humerus lengthening with the precice internal lengthening.
Aequalis humeral nail rationale the aequalis humeral nail has been designed to maximize tuberosity fragment fixation and provide stable support for the humeral head, resulting in improved proximal humeral reconstruction and fixation in osteoporotic bone. 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. Treatment of proximal humerus fractures with the stryker t2 proximal humeral nail. Dec 16, 2008 bent nails with oblique head interlocking bolts appeared to be the most dangerous in relation to the axillary nerve.
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