Master the treatment of humeral shaft fractures with a minimally invasive approach. This training offers a technical immersion in bridge plating osteosynthesis, focusing on tissue preservation, minimizing bleeding, and, crucially, protecting the radial nerve.

Training Focus:

• Minimally invasive treatment of humeral shaft fractures.
• Use of bridge plating.
• Strategic incisions for tissue preservation and radial nerve protection.
• Creation of a submuscular tunnel for plate passage.
• Sequential fixation and precise fragment alignment.

Detailed Content:

• Strategic Incisions and Initial Exposure: Learn to make proximal incisions following the biceps-deltoid interval and distal incisions slightly lateral, allowing for identification and protection of the radial nerve. Master dissection following the orientation of muscle fibers to minimize muscle cutting and bleeding.
• Use of Retractors and Radial Nerve Protection: Understand the use of medial and lateral retractors, with critical attention to the contraindication of the lateral Hohmann retractor, which significantly increases the risk of radial nerve injury. Ensure visualization and protection of the radial nerve throughout the procedure.
• Plate Preparation and Tunnel Creation: Develop the skill of dissecting with a periosteal elevator, following the humeral shaft to prepare a tunnel. Learn to create the tunnel from distal to proximal and then from proximal to distal, with constant palpation to ensure remaining on the bone surface and avoiding instrument deviation.
• Plate Verification and Positioning: Learn how to verify plate size for conformity with implant length and adjust the incision line for a more medial approach if necessary, advancing plane by plane and coagulating to optimize visualization.
• Plate Passage with Digital Guidance: Master the technique of passing the plate through the tunnel with the aid of a finger as a guide, palpating the end of the plate to direct it flush to the bone and avoid muscle interposition. The assistant maintains slight traction to prevent overlapping of bone fragments.
• Sequential Fixation and Precise Alignment: Learn to fix the plate step-by-step, starting with a distal screw for centralization. Proceed with the insertion of a proximal screw and, with slight traction and fragment alignment, insert additional screws (second distal, second proximal, and third, if space allows) before final tightening to permit adequate manipulation and alignment.

Included Material:

• Complete Technical PDF: Detailed didactic document describing the minimally invasive surgical procedure for the treatment of humeral shaft fractures with bridge plating, from incisions to final fixation.

Elevate your skills in humerus surgery. Enroll now and master advanced techniques of bridge plating osteosynthesis, ensuring superior results and radial nerve safety in your patients.