An innovative technique of rear entry creation for retrograde humeral nailing: how to avoid iatrogenic comminution.

Background: Antegrade and retrograde nails are widely used for intramedullary fixation of humeral shaft fractures. Creating the rear entry is the crucial step for retrograde nailing. The common manual technique is associated with considerable risks of additional iatrogenic comminution of the distal humerus.

Lateral cortical notching in specific cases of delayed unions or nonunions after intertrochanteric and reversed fractures.

Background: Stabilization of both intertrochanteric and reversed trochanteric fractures is commonly performed by proximal femoral nailing. However, biomechanics significantly differ between these two fracture types.

Patients And Methods: In this study we report on the occurrence of delayed union or nonunion after inter- or reversed trochanteric fractures in eight patients (7 females and 1 male).

Locking plate fixation of humeral head fractures with a telescoping screw. A comparative biomechanical study versus a standard plate.

Objectives: Locking plate fixation of humeral head fractures bares the risk of glenohumeral screw penetration. In order to circumvent this problem it is recommended to insert shorter locking screws having at least a 6mm distance to the humeral head cortex. This in turn may reduce fixation stability and may lead to early varus displacement.

Internal fixation of intracapsular hip fractures with a dynamic locking plate: initial experience and results for 83 patients treated with a new implant.

The results of treatment for 83 patients treated with a new implant designed specifically for the internal fixation of intracapsular hip fractures are reported. Nonunion occurred in one out of the 37 undisplaced fractures (3%) and seven out of the 46 displaced fractures (15%). In addition, four patients developed avascular necrosis (5%), one developed a fracture around the distal screws and another developed deep wound infection.

Fixation of Proximal Humeral Fractures with an Intramedullary Nail: Tipps and Tricks.

Antegrade interlocking nailing has been established as a valid option of treatment in proximal humeral fractures which follows the principles of minimum invasive surgery. The introduction of angular stability into intramedullary nailing has increased the stability of reconstruction even in osteoporotic fractures. The outcome of the surgical procedure essentially depends on the adequate intraoperative management of the specific features and challenges of the corresponding fracture type.