Suprapatellar versus infrapatellar approach for intramedullary nail fixation of tibial shaft fractures: a review of the literature.

Semi-extended suprapatellar intramedullary nail fixation of tibial fractures has recently been gaining popularity. Several recent studies and meta-analyses compare the outcomes of the suprapatellar approach with the traditional infrapatellar approach. Despite concerns with intra-articular placement of instruments, studies show the suprapatellar approach to be a safe alternative.

The Relationship of Multiplanar Distal and Uniplanar Proximal Interlocking Screws to Neurovascular Structures with the Depuy Synthes Humeral Nail-EX: An Anatomic Study.

Objective: To determine the proximity of neurovascular structures to multiplanar distal interlocking screws and proximal interlocking devices for an antegrade inserted humeral nail.

Methods: Humeral nails (Depuy Synthes Humeral Nail-EX, Paoli, PA) were inserted into 10 matched cadavers with 3 distal interlocking trajectories: anterior to posterior (A-P), anterolateral to posteromedial, and anteromedial to posterolateral (AM-PL). The distance of the screw path and screw head to the radial, lateral antebrachial cutaneous nerve (LACN), and median nerves and the brachial artery was measured.