Proximal humerus fractures in elderly patients require effective stabilization with minimal tissue aggression. This training presents a surgical approach using a long intramedullary nail, guided by fluoroscopy, which preserves the rotator cuff and ensures secure fixation. The technique is demonstrated step by step from a surgical perspective, focusing on anatomical and biomechanical precision.

Training Focus:

• Surgical positioning for exposure of the proximal humerus.
• Anatomical marking and insertion of the guide wire with radiographic control.
• Muscle dissection and preservation of the rotator cuff.
• Manipulation with Kirschner wire used as a joystick.
• Insertion of a long intramedullary nail with proximal and distal locking.
• Anatomical repair of the rotator cuff with absorbable sutures.
• Fluoroscopic control in multiple projections.

Detailed Content:

• Optimized Exposure of the Proximal Humerus: Positioning technique with elevated headboard for efficient anatomical access.
• Precise Radiographic Marking: Use of Kirschner wire and dermography for sagittal alignment.
• Muscular and Tendinous Preservation: Respectful dissection of deltoid fibers and controlled tenotomy of the cuff.
• Joystick for Humeral Head Alignment: Safe manipulation for correction of angulation and centralization of the entry point.
• Stable Intramedullary Fixation: Insertion of a long nail with multiple locking screws, including metaphyseal.
• Rigorous Fluoroscopic Control: Anteroposterior and lateral images to ensure parallelism and implant precision.
• Anatomical Repair of the Cuff: Absorbable sutures previously positioned for functional closure.
• Systematized Surgical Sequence: Practical step-by-step for direct application in the operating room.

Included Material:

Detailed PDF: The complementary material presents the complete surgical protocol, including radiographic images, detailed operative sequence, rotator cuff care, strategic positioning of the image intensifier, and techniques for distal locking. Recommended for quick consultation and preoperative review.

Master the intramedullary nail technique for proximal humerus fractures. Enroll now and elevate your surgical practice with anatomical and biomechanical precision.