The complexity of proximal humerus fractures requires approaches that preserve function and minimize morbidity. This training offers a technical immersion in osteosynthesis with intramedullary nail, using minimally invasive approaches and a proximal fragment manipulation technique with "joystick," focusing on the recovery of axis, rotation, and version of the humeral head without the need for precise anatomical reduction.

Training Focus:

• Osteosynthesis of proximal humerus fractures with intramedullary nail.
• Minimally invasive reduction and fixation techniques.
• Fragment manipulation with "joystick" for optimization of the angle of attack.
• Precise measurement of the intramedullary nail.
• Fixation with proximal and distal locking screws.

Detailed Content:

• Proximal Fragment Manipulation with "Joystick": Methodology for optimization of the guide wire angle of attack, ensuring ideal positioning and improving exposure of the transition between the greater tuberosity and the humeral head.
• Minimally Invasive Surgical Approach: Details of the approach via rotator cuff for access and exposure of the region, minimizing tissue trauma.
• Optimization of Guide Wire Introduction: Strategies for precise positioning of the guide wire in the humeral head, assisted by radiographic confirmation and the use of "joystick" to obtain AP and lateral images.
• Precise Measurement of the Intramedullary Nail: Measurement protocols using an external guide, with attention to anatomical particularities of the distal humerus to avoid undersizing or oversizing of the implant.
• Intramedullary Nail Insertion Technique: Approach for manual introduction of the nail, aiming to prevent the use of hammer and reduce the risk of iatrogenic fractures.
• Stable Fixation with Locking Screws: Methodology for insertion of proximal and distal locking screws through mini approaches, including fixation of the calcar, with focus on recovery of axis, rotation, and version of the humeral head.
• Functional Reduction Strategies: Osteosynthesis principles that prioritize functional and biomechanical recovery of the humerus, understanding that precise anatomical reduction is not essential in this type of fracture.

Included Material:

• Detailed PDF: A detailed document complements the training, objectively addressing the crucial steps of the procedure: manipulation with "joystick," planning with image intensifier, surgical approaches, guide wire introduction, measurement and insertion of the intramedullary nail, and fixation of proximal and distal locking screws, highlighting the objective of recovery of axis, rotation, and version of the humeral head for the success of the intervention.

Enhance your trauma surgery skills. Register now and master the technique in the treatment of proximal humerus fractures.