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Intramedullary Locking Nail Fixation of Proximal Humerus Fractures: Rationale and Technique

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Proximal Humerus Fractures

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Abstract

Displaced, unstable two-, three-, and four-part proximal humerus fractures with a vascularized and attached head fragment require reduction and internal fixation. However, optimal surgical treatment remains controversial. Based on our experience, intramedullary (IM) nailing with interlocking screws does provide a suitable alternative to percutaneous pinning and locking plating with the benefits of both (minimal soft-tissue dissection, adequate fixation strength). Analysis of the common complications and technological problems related to previous conventional IM nails have allowed us to define the rationale and characteristics of the ideal IM locking nail. The novel design of the Aequalis IM locking nail combines unique features that allow a less invasive surgical intervention, sustain the vascularization of the fracture fragments, angular stability of proximal fixation, and optimal screw orientation for fixation of the tuberosities. The percutaneous approach for a two-part fracture and the superior transdeltoid approach to fix a three- or four-part fracture are described, and the encouraging results of this novel IM locking nail are reported.

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Author information

Authors and Affiliations

  1. Department of Orthopaedic Surgery and Sports Traumatology, L’Archet 2 Hospital, 151, route de St Antoine de Ginestière, Nice, 06200, France

    Pascal Boileau & Thomas d’Ollonne

  2. Western Orthopaedics PC, 1830 Franklin Street, Suite 450, Denver, CO, 80218-1126, USA

    Armodios M. Hatzidakis

  3. Department of Orthopedics, Mayo Clinic, 200 1st St. SW, Rochester, MN, 55902, USA

    Mark E. Morrey

Authors
  1. Pascal Boileau
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  2. Thomas d’Ollonne
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  3. Armodios M. Hatzidakis
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  4. Mark E. Morrey
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Corresponding author

Correspondence to Pascal Boileau .

Editor information

Editors and Affiliations

  1. Department of Orthopedic Surgery, Georgia Regent's University, Augusta, Georgia, USA

    Lynn A. Crosby

  2. Department of Orthopedic Surgery, George Washington University, Washington, District of Columbia, USA

    Robert J. Neviaser

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Boileau, P., d’Ollonne, T., Hatzidakis, A.M., Morrey, M.E. (2015). Intramedullary Locking Nail Fixation of Proximal Humerus Fractures: Rationale and Technique. In: Crosby, L., Neviaser, R. (eds) Proximal Humerus Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-08951-5_5

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  • DOI: https://doi.org/10.1007/978-3-319-08951-5_5

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-08950-8

  • Online ISBN: 978-3-319-08951-5

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