TY  - JOUR
A1  - ,  
T1  - A new straight proximal humeral nail: a cadaveric study of itsanatomical relationships
JO  - Eur. J. Anat.
SN  - 1136-4890
Y1  - 2012
VL  - 16
SP  - 184
EP  - 189
UR  - http://www.eurjanat.com/web/paper.php?id=120025jg
KW  - Shoulder
KW  - Fractures
KW  - Fixation
KW  - Neurovascular injury
N2  - New humeral nailing systems appear constantly in the market, but few anatomical studies assessing the potential risks of neurovascular injury, exist. The aim of this study is to determine the potential risk of neurovascular injury during proximal and distal locking. An anatomical analysis was carried out in cadavers where a new straight proximal humeral nail had been inserted. The nail entry point was always located medially to the myotendinous junction of the supraspinatus muscle, therefore affecting only muscle fibres. The nail entry point was surrounded by articular cartilage of the humeral head. The axillary nerve and the posterior humeral circumflex artery were at safe distances (>2cm) from all proximal and distal locking screws. The radial nerve and its accompanying artery, the <i>profunda brachii</i> artery, were at risk whenever medial cortex violation happened, as they were located within 1cm of the exit point of the most distal locking screw. The straight humeral nail analysed in the current study seems to be more secure in relation to the neurovascular injury potential when compared to previously reported ones. Only the incorrect selection of the length of the most distal locking screw may lead to injury of the radial nerve and/or <i>profunda brachii</i> artery; therefore, close monitorisation during the insertion of this distal locking screw is recommended.
ER  -