Next generation distal locking for intramedullary nails using an electromagnetic xrayradiationfree real. We performed mechanical tests to investigate whether retrograde intramedullary nailing has fixation stability comparable to those of anterograde intramedullary nailing and locking plate which achieve clinically favorable outcomes. The proper nail length when inserted antegrade should extend from sub chondral bone proximally, to 1cm above the olecranon fossa distally. With the titanium spiral blade for humeral nail, fractures of the humeral diaphysis with proximal involvement beyond the locking parameters of locking bolts or locking screws may be treated. An insafelock humeral nail was used for each right humerus and a trigen humeral nail was used for each left humerus. Trigen humeral nail antegrade mode only specifications driving end of nail proximal lock nondriving end of nail distal lock 18 28 lengths note.
The t2 proximal humeral nail is intended to be used for various types of proximal andor diaphyseal fractures of the humerus. 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. The retrograde nail length is deter mined by measuring the distance from 1cm above the olecranon fossa to the center of the humeral head. About europe pmc funders joining europe pmc governance roadmap outreach. There is a unique thread inside the hole to make a locking mechanism between the im nail and proximal screws. Insafelock humeral nail provides a safe application for. 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. Surgical technique for nail removal article pdf available in acta orthopaedica belgica 752. The t2 proximal humeral nail is intended for single use only. With the multiloc humeral nailing system, synthes opens up opportunities for the treatment of humeral fractures.
The first and only virtual realtime imaging system for distal locking, new technology that offers full surgeon control, a reduction in radiation exposure, and shorter procedures from im nailing. Pdf proximal humerus fractures are one of the most common fractures. 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. Before insert the nail the reduction can be achieved manually, using a reduction table, an external.
Intramedullary nail for treating diaphyseal and supracondylar fractures. Surgical technique for the trigen humeral nail system. The old adage that a nail is a nail and a plate is a plate has been proven patently false through rigorous biomechanical and controlled study paradigms. Final seating of the screw should always be under manual control using the straight ratcheting driver to avoid over insertion of the screw in osteoporotic bone. Trigen humeral nailing includes a 16cm proximal straight nail, a 16cm proximal bent nail, and a full line of long bent nails. In the final analysis, the preferred treatment is that which addresses the needs of the specific patient. For the proximal humerus, the selflocking screw type of the im nail trigen humeral nail. Enhanced fixation dedicated instruments for blocking screws and extension nailing. Jointpreserving palliative surgery using selflocking screws of. However, we found the application of the distal locking screws in the trigen humeral nail with fluoroscopic guidewire and freehand technique with prolonged duration and similar safety design when compared with insafelock nails. The combination of minimally invasive surgical techniques with biomechanical design parameters to optimize bone regeneration after injury is a highly implant and instrumentdependent process. Next, defendant contends that plaintiff fails to plead sufficient facts to state a plausible breach of implied warranties claim, specifically contending that plaintiff fails to establish that the trigen humeral nail system was not merchantable at the time of sale, how the trigen humeral nail system was defective, and how any defect proximately. Expert humerusnagelsystem operationstechnik depuy synthes 1.
The humeral universal nail system from the versanail platform offers options to treat a range of humeral fractures using either the antegrade or retro. The trigen humeral nail system is designed specifically for the treatment of proximal humeral fractures. Trigen humeral nail proximal and long trigen hindfoot nail. Trigen humeral nail surgical technique pdf writer telegraph.
The compliance of the nail construct was adjusted by overdrilling the near cortex reliable fracture union since the surgeon can. The trigen hfn features an oblique locking configuration that allows surgeons to maximize thread purchase by locking into better bone. Such fractures were classified by neer as group i fractures, and were estimated to comprise over 85% of all proximal humerus fractures. Intertan nails designed for stability the trigen intertan nail was designed as a trochanteric portal intramedullary nail especially shaped for fractures of the proximal femur. Pdf management of proximal humerus fractures in adults.
Descriptive data of the different nails tested can be found in table table1. From january 2004 to december 2008, 64 elderly patients age 60 years old with displaced proximal humeral fractures were treated using trigen phn. Discovery elbow system ulna component with bond coating. Centronail humeral instruments box, complete 1789911. When locking with a spiral blade, the end cap must always be inserted into the nail. Jul 29, 2015 the best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration.
The trigen hfn advantage allows surgeons to target screws through. Russelltaylor deltatibial interlocking nail technique 598 kb recon interlocking. Fluoroscopic freehand and electromagneticguided targeting system for distal locking screws of humeral intramedullary nail. This publication is not intended for distribution in the usa. Six different commercially available proximal humeral nails were implanted. Efforts to prevent iatrogenic neurovascular injuries with humeral intramedullary nailing lead to design new implants and inside to out distal locking.
Specifications trigen tan nail material ti6al4v diameter 10, 11. Humeral nail provides new possibilities for the treatment of proximal. 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. Jun 11, 2015 next, defendant contends that plaintiff fails to plead sufficient facts to state a plausible breach of implied warranties claim, specifically contending that plaintiff fails to establish that the trigen humeral nail system was not merchantable at the time of sale, how the trigen humeral nail system was defective, and how any defect proximately. 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. The modular implant system, consisting of a short and long nail with multiple locking options, covers a wide application range to address simple and complex fractures. The trigen intertan nail was designed as a trochanteric portal intramedullary nail especially shaped for fractures of the proximal femur. Expert humeral nail antegrade insertion locking with spiral blade. Refer to the sureshot user manual 71181540 for details about the sureshot distal. All trigen locking screw measuring devices, measure from bottom of head to the last complete thread of screw. Thus, the screw itself is longer than the measurement and adding length is not necessary. The versanail humeral universal 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. Phn proximal humerus nail and expert phn, the smith and nephew trigen. Intramedullary fixation of proximal humerus fractures.
The humeral nail system can be used with or without the sureshot distal targeting system. Humerus intramedullary nail all medical device manufacturers. Find your humerus intramedullary nail easily amongst the 32 products from the leading brands b braun, wright, depuy. Trigen humeral nails have a favor in terms of safety against the other nails in the market. Risk assessment of retrograde intramedullary nailing for. Since there was no specific precice nail for humerus lengthening at the time, offlabel tibial or femoral nails wereutilized. Surgical technique instruments and implants approved by the ao foundation.
Uniflex humeral nail surgical technique the uniflex humeral nail system was developed in conjunction with ralph b. To our knowledge, this is the largest case series available reporting the use of fully implantable im lengthening nails for humeral lengthening. Reduced flexion leads to less pull from the quadriceps muscle, helping to avoid fracture malreductions and malalignment. Pelletier 1, david bell, hans peter boegl 2, todd gothelf 1. 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 three types of internal fixationwere applied following the standardized surgical procedures. Both antegrade femoral nails are designed to accommodate a standard femoral locking mode or the recon locking mode in the same leg. Instruments and implants approved by the ao foundation. Download download trigen humeral nail surgical technique pdf writer read online read online trigen humeral nail surgical technique pdf writer official fulltext paper pdf. The purpose of this study was to evaluate the functional outcome of using the trigen proximal humeral nail phn for the treatment of displaced proximal humeral fractures in elderly patients.
Pdf fluoroscopic freehand and electromagneticguided. A guide wire marks the prescribed path into the intramedullary canal and secures alignment of the fragments while the cannulated nail is being inserted over the wire solid nail design will not allow this procedure. Jointpreserving palliative surgery using selflocking screws. Do not operate the trigen sureshot targeter within 200mm of an installed pacemaker.
Descriptive data of the different nails tested can be found in table 1. 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. Chn cannulated humeral nail system a brief and concise description of each system is enclosed as follows. The polarus locking humeral rod and polarus plus humeral rod are cannulated intramedullary humeral rods that feature a tapered profile with a spiral array of proximal. Surgical technique this publication is not intended for distribution in the usa. Verify the position and read the nail length directly off the ruler. Hybrid bits combine rollercone and polycrystalline diamond compact pdc cutting elements to. It is a computerassisted orthopaedic surgery tool to aid the surgeon with drill positioning for screws during intramedullary nail implantation.
This brochure is presented to demonstrate the surgical technique. Trigen meta nail tibia trigen meta nail femur trigen knee nail retrograde femoral technique 3. In proximal humeral fracture except ao classification 11a1, fixations with a locking plate and nails are recommended. The trigen hindfoot fusion nail hfn brings the simplified instrumentation of the trigen nail system to the hindfoot. Solid humeral nail uhn and proximal humeral nail phn. Once the nails were placed, proximal and distal region of the nails were dissected to evaluate the relationship between screws and adjacent anatomical structures. Examples of specific indications according to ao classification include type afractures, dislo.
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. Features the following features are available with the merge orthotemplates library. Trigen humeral nail features include trapezoidal nail profile, four multiplanar proximal screws and multiple lengths bent and straight. Cfncannulated femur nail system is a curvedbowed lntramedullaryim nail in a right and left configuration to fit the natural bow of.
Orthopaedic templating after you calibrate your image and select a merge healthcare implant overlay, the application. Trigen intramedullary nailing system trigen sureshot distal targeting system trigen meta nail retrograde femoral nail trigen meta nail tibial nail trigen meta nail nailing in extension instrumentation trigen fan femoral antegrade nails trigen tan trochanteric nails trigen intertan intertrochanteric antegrade nail trigen hindfoot fusion nail trigen humeral nail with sureshot. Sep 19, 2012 the first and only virtual realtime imaging system for distal locking, new technology that offers full surgeon control, a reduction in radiation exposure, and shorter procedures from im nailing. Smith and nephew, usa has been introduced to inhibit loosening failure of osteoporotic bone. Michael hoffmann, md, mba, malte schroder, md, wolfgang lehmann, md, phd, michael kammal, md, johannes maria rueger, md, phd, and andreas herrman ruecker, md. The duration of the each screw was assessed via a stopwatch. Antegrade and retrograde femur operative technique. Humeral lengthening with the precice magnetic lengthening nail. A new approach for the treatment of proximal humeral.
Pdf intramedullary fixation of proximal humerus fractures. Move the image intensifier to the proximal humerus, position the distal end of the ruler at the skin mark, and take an ap image. Merge does validation of each orthotemplate library release with the latest version of. Reduced flexion leads to less pull from the quadriceps muscle, helping. Orthopaedic division 1450 east brooks road memphis, tn 3 8 1 16 901 3995153 name of device. Expert humeral nail and expert proximal humeral nail. The t2 femoral nailing system offers a universal left and right nail in addition to an antegrade or retrograde approach that may reduce inventory. There are no changes in intended use, performance specifications or method of operation. Composed from a unique blend of cellulose based fibres, durafiber. The titanium solid humeral nail system permits intramedullary fixation of a variety of humeral fractures using either an antegrade or retrograde approach. Smith and nephew, usa was inserted according to the usual proximal humeral im nail method. Humeral lengthening with the precice magnetic lengthening nail ahmed i. Anthology hip system and profix total knee system service.
Humerus nail and expert phn, the smith and nephew trigen phn. May 21, 20 the purpose of this study was to evaluate the functional outcome of using the trigen proximal humeral nail phn for the treatment of displaced proximal humeral fractures in elderly patients. Six different commercially available proximal humeral nails were implanted in 30 shoulders of 18 cadavers. The polarus humeral rod system is designed to provide fixation for 2, 3, and some 4part fractures of the proximal humerus through a minimally invasive surgical technique.
Electromagnetic distal targeting system does not reduce. These views are not to scale and should be used as a pictorial representation only. Im nails avoid the complications of pintract infection, regenerate fracture, or axial deformity postlengthening table table3 3. The trigen humeral nail system is indicated for proximal andor diaphyseal fractures of the humerus, nonunions. The t2 im nailing platform offers a combination of innovation, simplicity and versatility that is designed to suit your various needs. The intertan system offers anatomically shaped trapezoidal implants as opposed to conventional circular shaped intramedullary nails. Six different commercially available proximal humeral nails were. The trigen humeral nail provides new possibilities for the treatment of proximal humeral fractures and humeral shaft fractures. This website uses cookies to help you get the most out of your experience during your visit, and we can improve the content served to you by collecting statistical information. Uniflex humeral nail surgical technique zimmer biomet.
The best sleeping position for back pain, neck pain, and sciatica tips from a physical therapist duration. The technique description herein is made available to the healthcare professional to illustrate the authors suggested treatment for the uncomplicated procedure. Ma721 mr0 f1 510k summary of safety and effectiveness. Humeral lengthening with the precice magnetic lengthening.
Intramedullary fixation of proximal humerus fractures europe pmc. Jointpreserving palliative surgery using selflocking. The distal locking was successful obtained in all patients of group 2, while in two patients of group 1 polarus nail a missing of distal locking screw placement was noted. The principle of operation of the subject devices is identical to that of the predicates. 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. A number of studies have revealed very good functional results in conservatively managed minimally displaced, stable fractures of the proximal humerus10,18,24.
648 1027 905 676 49 1181 482 715 866 397 889 772 1332 1398 1364 1565 814 1554 516 1327 996 683 194 956 133 947 217 1485 646 801 651