ArticleInternational orthopaedics2017
Biomechanical evaluation of straight antegrade nailing in proximal humeral fractures: the rationale of the "proximal anchoring point".
Article in International orthopaedics, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed, 29 citations in OpenAlex.
- The ORIN-open reduction and intramedullary nailing-technique for 4-part proximal humerus fractures.JSES reviews, reports, and techniques · 2026Article
- Novel CT-based simulation reveals anterolateral surgical approach avoids acromial collision in antegrade humeral nailing.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- Therapeutic effect of titanium locking plate combined with suture anchor repair in proximal humeral fractures.Pakistan journal of medical sciences · 2025Article
- Straight intramedullary MultiLoc nails for displaced proximal humeral fractures: health status, radiographic results, clinical outcome, and complications.BMC musculoskeletal disorders · 2024Article
- Reverse Shoulder Arthroplasty for Proximal Humeral Fractures: Is the Bigliani-Flatow Stem Suitable for Tuberosity Fixation and Healing?Journal of clinical medicine · 2024Article
- Risk factors of poor mid-term shoulder functional outcomes of osteosynthesis using antegrade intramedullary nailing for humeral shaft fractures: a retrospective study with a minimum 5-year follow-up.BMC musculoskeletal disorders · 2024Article
- Straight antegrade humeral nailing and risk of iatrogenic injury of supraspinatus tendon footprint: An MRI study.Shoulder & elbow · 2023Article
- Risk Factors and Clinical Outcomes after Antegrade Intramedullary Nailing in Proximal Humeral Fractures: Insights and Implications for Patient Satisfaction.Journal of personalized medicine · 2023Article
- Intramedullary Nail for Treatment of Proximal Humeral Fracture: A Credible Fixation in Comminuted Calcar.Orthopaedic surgery · 2023Article
- Biomechanical evaluation of novel intra- and extramedullary assembly fixation for proximal humerus fractures in the elderly.Frontiers in bioengineering and biotechnology · 2023Article
- Blocking screw augmentation in intramedullary nailing for displaced surgical neck fractures of the proximal humerus.JSES reviews, reports, and techniques · 2022Article
- Proximal humeral nail for treatment of 3- and 4-part proximal humerus fractures in the elderly population: effective and safe in experienced hands.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2021Article
- Indications and results of osteosynthesis for proximal humerus fragility fractures in elderly patients.Orthopedic reviews · 2020Article
- Is distal locking screw necessary for intramedullary nailing in the treatment of humeral shaft fractures? A comparative cohort study.International orthopaedics · 2019Article
- The female geriatric proximal humeral fracture: protagonist for straight antegrade nailing?Archives of orthopaedic and trauma surgery · 2017Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 3 countries.
Funding
Abstract
purposeVarus failure is one of the most common failure modes following surgical treatment of proximal humeral fractures. Straight antegrade nails (SAN) theoretically provide increased stability by anchoring to the densest zone of the proximal humerus (subchondral zone) with the end of the nail. The aim of this study was to biomechanically investigate the characteristics of this "proximal anchoring point" (PAP). We hypothesized that the PAP would improve stability compared to the same construct without the PAP.
methodsStraight antegrade humeral nailing was performed in 20 matched pairs of human cadaveric humeri for a simulated unstable two-part fracture.
resultsBiomechanical testing, with stepwise increasing cyclic axial loading (50-N increments each 100 cycles) at an angle of 20° abduction revealed significantly higher median loads to failure for SAN constructs with the PAP (median, 450 N; range, 200-1.000 N) compared to those without the PAP (median, 325 N; range, 100-500 N; p = 0.009). SAN constructs with press-fit proximal extensions (endcaps) showed similar median loads to failure (median, 400 N; range, 200-650 N), when compared to the undersized, commercially available SAN endcaps (median, 450 N; range, 200-600 N; p = 0.240).
conclusionsThe PAP provided significantly increased stability in SAN constructs compared to the same setup without this additional proximal anchoring point. Varus-displacing forces to the humeral head were superiorly reduced in this setting. This study provides biomechanical evidence for the "proximal anchoring point's" rationale. Straight antegrade humeral nailing may be beneficial for patients undergoing surgical treatment for unstable proximal humeral fractures to decrease secondary varus displacement and thus potentially reduce revision rates.
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