Chinese Journal of Clinical Anatomy >
The entry point in antegrade humeral nailing: An anatomic study
Received date: 2014-07-08
Online published: 2015-04-21
Objective To investigate the entry point in antegrade humeral nailing for Chinese population. Methods （1）the relatively safe area was obtained though observation and the distance between the axillary nerve, anterior humeral circumflex artery, post humeral circumflex artery,long head of the biceps tendons, suprascapular nerve, suprascapular artery and the reference entry point on 8 fresh-frozen shoulder joints were measured; （2）the correct entry point was localized though insertion of a nail in simulated surgery on 60 humeri, which were divided equally into 6 groups. Results The relative safe area was located behind the long head of the biceps tendons and medial the supraspinatus tendon. The distance between the correct entry point and supraspinatus tendon was 8.5 mm; Distance between the correct entry point to the long head of the biceps tendons was（12.12±0.68）mm（11.69～13.57mm）. Conclusions It is important to obtain a correct entry point ，which can not only improve the accuracy in inserting the humeral nailing, but also reduce the postoperative complications.
Key words： Humeral; Intramedullary nail; Rotator cuff; Anatomic study
ZHOU Xian-Ting , TU Kai-Kai , TUN Yun-Jiang , SHU Chao-Yu , LIU Wei , HE Hang-Wen , DAN Cheng-Di , YANG Lei . The entry point in antegrade humeral nailing: An anatomic study[J]. Chinese Journal of Clinical Anatomy, 2015 , 33(2) : 134 -137 . DOI: 10.13418/j.issn.1001-165x.201
[1] Lin J. Treatment of humeral shaft fractures with humeral locked nail and comparison with plate fixation
[J]. J Trauma,1998, 44(5):859-864.
[2] Brumback RJ. The rationales of interlocking nailing of the femur, tibia, and humerus
[J]. Clin Orthop Relat Res,1996,(324):292-320.
[3] Hall RF Jr. Closed intramedullary fixation of humeral shaft fractures
[J]. Instr Course Lect,1987,36:349-358.
[4] Ingman AM, Waters DA. Locked intramedullary nailing of humeral shaft fractures. Implant design, surgical technique, and clinical results
[J]. J Bone Joint Surg Br, 1994,76(1):23-29.
[5] McCormack RG, Brien D, Buckley RE, et al. Fixation of fractures of the shaft of the humerus by dynamic compression plate or intramedullary nail. A prospective, randomised trial
[J]. J Bone Joint Surg Br, 2000, 82(3):336-339.
[6] Rommens PM, Verbruggen J, Broos PL. Retrograde locked nailing of humeral shaft fractures. A review of 39 patients
[J]. J Bone Joint Surg Br, 1995, 77(1):84-89.
[7] Chapman JR, Henley MB, Agel J, et al. Randomized prospective study of humeral shaft fracture fixation: intramedullary nails versus plates
[J]. J Orthop Trauma, 2000, 14(3):162-166.
[8] Cox MA, Dolan M, Synnott K, et al. Closed interlocking nailing of humeral shaft fractures with the Russell-Taylor nail
[J]. J Orthop Trauma, 2000, 14(5):349-353.
[9] Ajmal M, O'Sullivan M, McCabe J, et al. Antegrade locked intramedullary nailing in humeral shaft fractures
[J]. Injury, 2001, 32(9):692-694.
[10]Wallny T, Sagebiel C, Westerman K, et al. Comparative results of bracing and interlocking nailing in the treatment of humeral shaft fractures
[J]. Int Orthop,1997, 21(6):374-379.
[11]Gradl G, Dietze A, Arndt D, et al. Angular and sliding stable antegrade nailing (Targon PH) for the treatment of proximal humeral fractures
[J]. Arch Orthop Trauma Surg, 2007, 127(10):937-944.
[12]Agel J, Jones CB, Sanzone AG, et al. Treatment of proximal humeral fractures with Polarus nail fixation
[J]. J Shoulder Elbow Surg, 2004,13(2):191-195.
[13]Mall NA, Kim HM, Keener JD, et al. Symptomatic progression of asymptomatic rotator cuff tears: a prospective study of clinical and sonographic variables
[J]. J Bone Joint Surg Am, 2010, 92(16):2623-2633.
[14]Euler SA, Hengg C, Kolp D, et al. Lack of fifth anchoring point and violation of the insertion of the rotator cuff during antegrade humeral nailing
[J]. Bone Joint J, 2014, 96-B(2):249-253.
[15]Boileau P, Walch G. The three-dimensional geometry of the proximal humerus. Implications for surgical technique and prosthetic design
[J]. J Bone Joint Surg Br, 1997, 79(5):857-865.
[16]Farragos AF, Schemitsch EH, McKee MD. Complications of intramedullary nailing for fractures of the humeral shaft: a review
[J]. J Orthop Trauma, 1999, 13(4):258-267.
[17]Chen YF, Zhu NF, Zhang CQ, et al. The relevance of the anatomical basis of fracture for the subsequent treatment of the anterior humeral circumflex artery and the axillary nerve
[J].Int Orthop, 2012, 36(4):783-787.
[18] 蔡俊丰, 李旭, 刘林，等. 肱骨近端骨折内固定相关应用解剖学研究
[J]. 中国临床解剖学杂志, 2011, 29(3):268-271.
[19] 朱乃锋，张睿，陈云丰，等. 肱骨近端骨折手术安全区的解剖学研究和临床意义
[J]. 中国临床解剖学杂志, 2011, 29(2):168-170.
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