Synthes MultiLoc Proximal Humeral Nail User manual

MultiLoc Proximal Humeral Nail.
Proximal humeral nail with multiple
locking options for simple and complex
fractures.
Technique Guide

Introduction
Surgical Technique
Product Information
Image intensifier control
MultiLoc Proximal Humeral Nail Technique Guide Synthes
Table of Contents
MultiLoc Proximal Humeral Nail 2
Screw Configuration 4
AO Principles 5
Indications 6
Clinical Cases 7
Patient Positioning 10
Approach 11
Opening the Humerus 13
Nail Insertion 16
Nail Positioning 18
Proximal Locking 22
MultiLoc Screws 22
3.5 mm Locking Screws 26
Distal Locking 30
End Cap Insertion 34
Implant Removal (Optional) 37
Implants 40
Instruments 45
Set Lists 54

MultiLoc Screws
1Blunt screw tips to minimize the risks
associated with secondary screw
perforation
2Countersunk screwheads to reduce
implant prominence
3Four suture holes per screw, for
attachment of the rotator cuff muscles
4Option for secondary 3.5 mm locking
screws, for improved stability where
needed*
MultiLoc Proximal Humeral Nail.
2 Synthes MultiLoc Proximal Humeral Nail Technique Guide
Proximal humeral nail with multiple locking options for
simple and complex fractures.
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MultiLoc Proximal Humeral Nail
– Cannulated nails in right and left
designs, 8.0 mm and 9.5 mm diame-
ters, and 160 mm length, to ensure
optimal fit in the canal
– Straight nail for central insertion
point, to avoid potential insertion
through the fracture site, increasing
biomechanical stability
Angular Stable Locking System ASLS
(optional)
Improved fixation in poor bone quality.
MultiLoc Proximal Humeral Nail Technique Guide Synthes 3
* Comparative testing was conducted by Synthes
with the MultiLoc Humeral Nail construct
implanted in polyurethane foam block material of
multiple densities. Static bend testing was
conducted to compare the stability of the nail
construct with and without the secondary 3.5 mm
locking screws assembled with the proximal
lateromedial (LM) screws. The static bending force
was applied to the test constructs in an eccentric,
mediolateral direction.Testing was conducted with
the test sample constructs implanted in foam block
material with densities of 5.5 pcf (pounds per
cubic foot), 7.5 pcf, and 10 pcf. Failure was
defined as varus collapse of 10 mm or cutout of
the proximal screws. Results showed as much as a
45% increase in construct stability when the
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– Ascending screw option to provide
support to the calcar
– Multiplanar distal locking options for
less implant toggling in the medullary
canal
– Fully targeted locking options for
accurate screw insertion
– Polyethylene inlay for secure screw
fixation
secondary 3.5 mm locking screws were assembled
with the proximal LM screws and the construct
was subjected to the static mediolateral bending
force. Test results showed that in 10 pcf foam
material, the MultiLoc Humeral Nail construct
failed at 315 N (mean) with secondary locking
screws assembled with LM screws vs. 230 N
(mean) without secondary locking screws. In 7.5
pcf foam material, the construct failure occurred at
141 N (mean) with secondary 3.5 mm locking
screws vs 123 N (mean) without secondary 3.5 mm
locking screws. In 5.5 pcf foam material, the
construct failed at 137 N (mean) with secondary
3.5 mm locking screws vs. 94 N (mean) without
secondary 3.5 mm locking screws.