title: UPPER LIMB TRACTION DEVICE FOR ANTEROGRADE INTRAMEDULLARY LOCKED NAIL OF HUMERAL SHAFT FRACTURES.
abstract: Diaphyseal fractures of the femur and tibia in adults are mostly treated surgically, usually by means of intramedullary locked-nail osteosynthesis. Some comminuted and/or highly deviated shaft fractures may present a veritable technical challenge. Fracture (or orthopedic) tables, which enable vertical, horizontal and rotational instrumental stabilization of the limb, greatly facilitate reduction and implant placement maneuvers and are widely used by orthopedic surgeons. Humeral shaft fractures are mostly treated nonsurgically. However, some cases with indications that are well defined in the literature require surgical treatment. They can be fixed by means of plates or intramedullary nails, using anterograde or retrograde routes. In the humerus, fracture reduction and limb stabilization maneuvers for implantation of intramedullary nails are done manually, usually by two assistants. Because muscle fatigue may occur, this option may be less efficient. The aim of this paper is to present an external upper-limb traction device for use in anterograde intramedullary locked-nail osteosynthesis of humeral shaft fractures that enables vertical, horizontal and rotational stabilization of the upper limb, in a manner similar to the device used for the lower limbs. The device is portable, of simple construction, and can be installed on any operating table equipped with side rails. It was used for surgical treatment of 29 humeral shaft fractures using an anterograde locked intramedullary nail. Our experience was extremely positive. We did not have any complications relating to its use and we believe that it notably facilitated the surgical procedures.
authors.affiliation: Attending Physician in the Specialization Course on Shoulder and Elbow Surgery (Cecoc), Hospital Madre Teresa; Orthopedist at Hospital Governador Israel Pinheiro (HGIP-IPSEMG), Belo Horizonte, Minas Gerais.
authors.forename: Mário Chaves
authors.initials: MC
authors.lastname: Corrêa
authors.affiliation: Resident Physician in Orthopedics and Traumatology at HGIP-IPSEMG, Belo Horizonte, Minas Gerais.
authors.forename: Felipe Antônio
authors.initials: FA
authors.lastname: Gomes
authors.affiliation: Resident Physician in Orthopedics and Traumatology at HGIP-IPSEMG, Belo Horizonte, Minas Gerais.
authors.forename: Daniel Campos
authors.initials: DC
authors.lastname: Linhares
authors.affiliation: Attending Physician in the Specialization Course on Shoulder and Elbow Surgery (Cecoc), Hospital Madre Teresa, Belo Horizonte, Minas Gerais.
authors.forename: Lucas Braga Jacques
authors.initials: LB
authors.lastname: Gonçalves
authors.affiliation: Attending Physician in the Specialization Course on Shoulder and Elbow Surgery (Cecoc), Hospital Madre Teresa, Belo Horizonte, Minas Gerais.
authors.forename: José Carlos Souza
authors.initials: JC
authors.lastname: Vilela
authors.affiliation: Head of the Orthopedics and Traumatology Service, Hospital Madre Teresa, Belo Horizonte, Minas Gerais.
authors.forename: Ronaldo Percopi
authors.initials: RP
authors.lastname: de Andrade
keywords: Diaphysis; Fracture fixation; Humeral fractures/surgery; intramedullary