Le clou huméral InSafeLock permet un positionnement sûr des vis de verrouillage proximale et distale: étude cadavérique

Abstract

IntroductionEfforts to prevent iatrogenic neurovascular injuries with humeral intramedullary nailing lead to design new implants and inside to out distal locking technique using an endopin aims to provide a safer screw application. InSafeLock (TST, Istanbul, Turkey) humeral nail have been recently developed to minimize the possible screw related complications. The anatomical relationship between locking screws and neurovascular structures with the application time were compared between Trigen Humeral Nail (Smith and Nephew, Memphis, USA) and InSafeLock Humeral Nail. HypothesisInSafeLock humeral nail would be safer than Trigen Humeral nail in terms of neurovascular injury. Materials and MethodsSeven cadavers were used with both shoulders and surgical application of two nails was performed as the manufacturer guide. An Insafelock humeral nail was used for each right humerus and a Trigen humeral nail was used for each left humerus. Once the nails were placed, proximal and distal region of the nails were dissected to evaluate the relationship between screws and adjacent anatomical structures. The duration of the each screw was assessed via a stopwatch. ResultsNo significant finding was noted for the relationship between the neurovascular structures and proximal screws in two groups. (p<0.05) The distal locking of the InSafeLock humerus nail had a shorter application time and no neurovascular damage was recorded. DiscussionThe newly developed Insafelock humerus nails are at least as safe and effective as current humeral nails available on the market. Additional benefits include the preservation of neurovascular structures, as the Insafelock humerus nail does not require the use of an extra incision. Furthermore, surgical time is significantly shorter with using distal endopin. Level of studyIII, controlled laboratory study.