Upper Arm Bone Fractures (Proximal Humerus Fractures): Fixation With a Bone Nail Animation

Upper Arm Bone Fractures (Proximal Humerus Fractures): Fixation With a Bone Nail Animation

This animation demonstrates the repair of an upper arm bone fracture, or proximal humerus fracture, using a short bone nail and screws. Here is a left upper arm bone with a fracture just below the top of the bone, or head of the humerus, that forms the ball and socket joint of the shoulder.

First, an incision is made at the front of the shoulder near the top of the upper arm bone. A guide pin is inserted through the upper arm bone from the top, and a reamer is drilled over it to create an entry hole for a bone nail. The guidewire is inserted further down the center of the upper arm bone, and another reamer is drilled over the guidewire to create more space for the nail.

Next, the nail will be connected to a targeting guide, which contains holes that align perfectly with the holes in the nail. The nail is inserted into the upper arm bone. Then, a small skin incision is made, and a drill guide is placed in the targeting guide and aligned onto the upper arm bone. A hole is drilled and measured. A screw of the measured length is inserted through the guide and screwed into the bone and the nail with a screwdriver.

These steps are repeated for the other screws at the top of the nail. At the bottom of the nail, smaller screws are inserted following the same steps: making small skin incisions, drilling and measuring holes, and inserting the screws through the targeting guide. The targeting guide is disconnected from the nail. The skin incisions will be closed, and the procedure is complete.