Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated Surgical Technique Humeral Interlocking Nail Intramedullary Nail System Humerus Nail Kit Code 08050001

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com ► Preparing the nail and instruments 8 ► Solid nail technique 10 ► Cannulated nail technique 11 ► Distal and proximal blocking 16 Intramedullary Nail System

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com This guide is designed to demonstrate the techniques that can be applied to the utilization of the ARZZT locked intramedullary nail for the humerus, and it is recommended for use by orthopedic traumatologists in the treatment of humerus fractures. The recommendations for their use do not presume to interfere with the surgeon’s experience, nor the particular needs of each patient, and follow the biomechanical principles of internal splints with treatment of diaphyseal and proximal fractures of the humerus....

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com Introduction Conservative treatment does not always lead to favorable results, and is linked to long periods of immobilization, as well as trophic and functional problems in the upper part of the affected extremity. The fracture line can extend from the metaphyseal area to the superior and inferior diaphyseal thirds (diaphyseal lesions or fractures). The management of these lesions caused by highenergy trauma, which are increasingly more frequent, has led to the development of implants like the ARZZT...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com The ARZZT solid and cannulated intramedullary nails for the humerus have the particular feature of being able to block the proximal part in three ways and on three planes, allowing for excellent fixation and stability with respect to both fracture lines and tuberosities (including diaphysis). The ARZZT intramedullary nails for the humerus are available in solid and cannulated versions, are made from a titanium 6AI4V alloy, and can be used at the discretion of the orthopedic surgeon, who must evaluation...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated Ins Hilden Arzzt Nail Systems, consisting of intramedullary solid and cannulated nails, end cap and locking screws, are intended for fixation of fractures of different types: of the shaft, open and closed shaft fractures; and malunion and non-unions of the Femur, Tibia, and Humerus. The diameter and longitude of the nail can be established by way of X-rays of—if possible—the healthy extremity, which are to be used as templates, taking into account the magnification, which varies between 10 and 15%. Some surgeons...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com Patient Positioning It is recommended to place the patient on the fracture table in a “beach chair” position, laying laterally or dorsally prone with the aim of facilitating both the reduction of the fracture and the surgical approach chosen by the surgeon. Beach chair position: The patient is placed seated with 30 to 60 degrees of flexion, the lower extremities are placed flexed over a bump, which allows for them to be supported, with the aim of diminishing venous stasis. Intramedullary Nail System

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com Preparing the nail and Instruments The nail must be assembled and calibrated before it is used inside the humerus in order to allow for the free passage of the screws and create exact symmetry with the instrumental frame. 1.Place the nail in the insertion handle, ensuring that the grooves line up, and attach it to the nail connector. (Picture) 2.Fasten the nail in the insertion sleeve with the nail connector, and tighten the handle firmly, using the Lhandled hexagon key (Allen), introducing it into...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com 5. Place the T-handled feeler gauge and insert the spacer to be used into the grooves of the feeler gauge. 6. Calibrate the distal arm, fastening it with the fastening screw and tightening it firmly with the Lhandled hexagon key (Allen), ensuring that the external sheaths for tissue protection of the internal sheaths (drill bit guides) line up perfectly with the distal orifices of the nail. 7. Ensure once more the firmness of the fastening screws. Remove the spacer and the T-handled feeler gauge. Intramedullary...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com Antegrade Solid Nail Technique Make an incision of the skin from the anterolateral border of the acromion in the distal direction, toward the insertion of the deltoid muscles. Incise the subcutaneous tissue, and separate the muscular fibers of the deltoids. Locate the supraspinatus tendon and divide it in line with its fibers. Using blunt dissection, retract both borders with sutures on the tendon, and expose a portion of the cartilage of the humeral head medially to the greater tuberosity. Access to...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com The point of access for the ARZZT humeral nail is found on the prolongation of the axis of the central humeral diaphysis, in the transition area between the bone and the cartilage. In the correct position with respect to the humeral head, the insertion point is found immediately beneath the tip of the acromion. Once the nail is attached to the fastener handle, it must be introduced by exerting firm manual pressure with rotational movements until the tip of the nail reaches the fracture area. Perform...

Intramedullary locked Nailing With Screws for Humerus Fractures Solid/Cannulated www.arzzt.com Distal and Proximal Blocking Place the exterior sheaths (for tissue protection) and interior sheaths (drill bit guides) in the orifices where the distal locking of the nail is to be performed. Mark its location on the skin. Makes two incisions of 5 mm each. Using a Kelly clamp, dissect the length and width of the wound. Introduce the external sheath (for tissue protection) with the sheath punch until the lateral cortex is located. Remove the sheath punch, position the internal sheath (3.5 mm drill bit...