Humeral Shaft Fracture - Bridge Plate Treatment

Master the treatment of humeral diaphysis fractures with a minimally invasive approach. This training offers a technical immersion in bridge plate osteosynthesis, focusing on tissue preservation, minimization of bleeding, and, crucially, protection of the radial nerve.

Training Focus:

• Minimally invasive treatment of humeral diaphysis fractures.
• Use of bridge plate.
• Strategic incisions for tissue preservation and protection of the radial nerve.
• Creation of a submuscular tunnel for plate passage.
• Sequential fixation and precise alignment of fragments.

Detailed Content:

• Strategic Incisions and Initial Exposure: Learn to perform proximal incisions following the biceps-deltoid interval and distal slightly lateral, allowing for identification and protection of the radial nerve. Master the dissection by following the orientation of the muscle fibers to minimize muscle cutting and bleeding.
• Use of Retractors and Protection of the Radial Nerve: Understand the use of medial and lateral retractors, with critical attention to the contraindication of the lateral Hohmann retractor, which significantly increases the risk of radial nerve injury. Ensure visualization and protection of the radial nerve throughout the procedure.
• Preparation and Creation of the Tunnel for the Plate: Develop the skill to perform dissection with a dissector, following the humeral diaphysis to prepare a tunnel. Learn to create the tunnel from distal to proximal and then from proximal to distal, with constant palpation to ensure staying on the bony surface and avoiding deviations of the instruments.
• Plate Verification and Positioning: Learn how to verify the plate size for compliance with the implant length and adjust the incision line for a more medial approach if necessary, advancing plane by plane and coagulating to optimize visibility.
• Plate Passage with Digital Guide: Master the technique of passing the plate through the tunnel with the help of your finger as a guide, palpating the end of the plate to direct it close to the bone and avoid muscle interposition. The assistant maintains light traction to prevent overlapping of the bone fragments.
• Sequential Fixation and Precise Alignment: Learn to fix the plate step by step, starting with a distal screw to center it.Proceed with the insertion of a proximal screw and, with gentle traction and alignment of the fragments, insert the additional screws (second distal, second proximal, and third, if space allows) before the final tightening to allow for proper manipulation and alignment.

Included Material:

• Complete Technical PDF: Detailed educational document describing the minimally invasive surgical procedure for the treatment of humeral diaphysis fractures with bridge plate, from incisions to final fixation.

Enhance your skills in humeral surgery. Enroll now and master advanced bridge plate osteosynthesis techniques, ensuring superior results and the safety of the radial nerve in your patients.