Intramedullary Nail for Proximal Humerus (03)

Proximal humerus fractures in elderly patients require effective stabilization with minimal tissue damage. This training presents a fluoroscopy-guided surgical approach using a long intramedullary nail that preserves the rotator cuff and ensures secure fixation. The technique is demonstrated step-by-step from a surgical perspective, focusing on anatomical and biomechanical precision.

Training Focus:

• Surgical positioning for exposure of the proximal humerus.
• Anatomical marking and guide wire insertion with radiographic control.
• Muscle dissection and rotator cuff preservation.
• Kirschner wire joystick-type manipulation.
• Insertion of a long intramedullary rod with proximal and distal locking.
• Anatomical repair of the rotator cuff using absorbable sutures.
• Fluoroscopic control in multiple projections.

Detailed Content:

• Optimized Exposure of the Proximal Humerus: Positioning technique with an elevated head for efficient anatomical access.
• Precise Radiographic Marking: Use of Kirschner wires and dermography for sagittal alignment.
• Muscle and Tendon Preservation: Respectful dissection of the deltoid fibers and controlled rotator cuff tenotomy.
• Joystick for Humeral Head Alignment: Safe manipulation for correcting the angle and centering of the entry point.
• Stable Intramedullary Fixation: Insertion of a long rod with multiple locking screws, including metaphyseal screws.
• Rigorous Fluoroscopic Control: Anteroposterior and lateral images to ensure parallelism and precision of the implants.
• Anatomical Rotator Cuff Repair: Absorbable sutures previously positioned for functional closure.
• Systematized Surgical Sequence: A practical step-by-step guide for direct application in the operating room.

Materials Included:

Detailed PDF: This supplementary material presents the complete surgical protocol, including radiographic images, a detailed operative sequence, rotator cuff care, strategic image intensifier placement, and techniques for distal nerve block. Recommended for quick reference and preoperative review.

Master the intramedullary nailing technique for proximal humerus fractures. Enroll now and elevate your surgical practice with anatomical and biomechanical precision.