Risk of Axillary Nerve Injury With Medial Support Screws in Intramedullary Nails: An Anatomical Study.

BACKGROUND

In recent years, intramedullary nails with medial support screws for proximal humeral fractures have become available. Although these devices have a potential risk of iatrogenic axillary nerve injury, no studies have investigated the anatomical relationship between the medial support screws in the modern intramedullary nail and the axillary nerve. This study aimed to clarify the anatomical relationship between the medial support screws in the intramedullary nail and the axillary nerve.

MATERIALS AND METHODS

In total, 29 cadaveric shoulders (mean age: 82.6 years old (range: 61-105); 15 males and 14 females) were included in this study. Shoulders within whole-body cadavers were used in all cases. A single proximal humeral nail with medial support screws (ARISTO Proximal Humeral Nail; MDM, Tokyo, Japan) was used. The distance of each medial support screw from the axillary nerve and its branches was measured.

RESULTS

In two (6.90%) of 29 shoulders, the axillary nerves came into contact with the medial support screws. In the remaining 27 of 29 shoulders (93.1%), the nerves were located proximal to the medial support screws.

CONCLUSION

Medial support screws in proximal humeral fracture nails had the potential to injure the axillary nerve and its branches.

Informations de copyright

Copyright © 2024, Kobayashi et al.

Déclaration de conflit d'intérêts

Human subjects: Consent was obtained or waived by all participants in this study. Fukuoka University - Medical Ethics Review Board issued approval U23-04-013. The Fukuoka University Medical Ethics Review Board conducts ethical reviews in accordance with the Declaration of Helsinki, the Ethical Guidelines for Life Sciences and Medical Research Involving Human Subjects (Ministry of Education, Culture, Sports, Science and Technology, Ministry of Health, Labour and Welfare, Ministry of Economy, Trade and Industry), the Act on the Protection of Personal Information and related laws, the Basic Principles for Human Genome Research (decided by the Council for Science and Technology, Bioethics Committee), the Fukuoka University Guidance for Non-medical Research Involving Human Subjects, and the Fukuoka University Medical Ethics Board Rules. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.