TRIGEN SURESHOT with the Humeral Nail

Challenges and Solutions


Challenges and Solutions

Challenge: Adjusting the C-arm for distal locking in humeral nail procedures
Solution: The position of the C-arm becomes less of a concern during the procedure because the surgeon has the ability to target the distal locking holes using the TRIGEN SURESHOT system for easier alignment and no radiation exposure 5

Challenge: Preventing possible axillary nerve damage 1,2
Solution:
The TRIGEN Humeral Nail with its versatile screw configuration was shown in a cadaver study to be one of the safest humeral nails for avoiding axillary nerve damage 3

Challenge: Limiting the risk of neurovascular injury during distal locking 4
Solution:
The TRIGEN Humeral Nail System with SURESHOT technology is designed to distal lock the nail first, using the electromagnetic wand and perfect circles method for fewer misses during drilling and screw insertion 5

Challenge: Decreasing unnecessary radiation exposure 6,7
Solution:
The number of fluoroscopy images are reduced significantly using the TRIGEN SURESHOT system, limiting the amount of radiation exposure to the patient, surgeon and OR staff5

Challenge: Having options for nail insertion
Solution:
The TRIGEN Humeral Nail System offers a straight and bent nail option. The 4 o lateral bend may ease nail insertion avoiding the acromion

References:
1. Perlmutter GS. Axillary nerve injury. Clinical orthopaedics and related research. 1999 Nov;(368):28-36.
2. Blum J, Rommens PM. Proximal interlocking of humeral intramedullary nails and risk of axillary nerve injury. Der Unfallchirurg. 2002 Jan;105(1):9-13.
3. Nijs S, Sermon A, Broos P. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study Patient Safety in Surgery. V.2: 2008.
4. Baltov AG, Tzachev NN, Tivchev NP, Iotov, AM. Operative treatment of humeral shaft fracture - interlocking nailing versus plating. European Federation of National Orthopaedics and Traumatology (8th Congress). Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue SUPP_1, 180.
5. Tornetta P, Patel P, Tseng S, Whitten A, Ricci W. Distal locking using an electromagnetic field guided computer based real time system. Poster presented at: Annual Meeting of the Orthopaedic Trauma Association; October 8-10, 2009; San Diego, CA
6. Center for Devices and Radiological Health, US Food and Drug Administration. Initiative to reduce unnecessary radiation exposure from medical imaging. http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/ RadiationDoseReduction/ucm199994.htm. Updated February 16, 2010. Accessed February 22, 2010.
7. Klein LW, Miller DL, Balter S, et al. Occupational health hazards in the interventional laboratory: time for a safer environment. Catheter Cardiovasc Interv. 2009;73(3):432-438.
8. Kraus R, Meyer C, Stahl JP, Schnettler R. Intraoperative radiation exposure in elastic stable intramedullary nailing (ESIN) during the growth period. Observations in 162 long bone shaft fractures. Unfallchirurg. 2007 Jan;110(1):28-32.
9. Sont WN, Zielinski JM, Ashmore JP, et al. First analysis of cancer incidence and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 2001;153(4):309-318.
10. Ashmore JP, Krewski D, Zielinski JM, Jiang H, Semenciw R, Band PR. First analysis of mortality and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 1998;148(6):564-574.
11. National Council on Radiation Protection and Measurements. The application of ALARA for occupational exposures. NCRP Statement No. 8. Issued June 8, 1999. http://www.ncrponline/. org/Publications/Statement_8.pdf. Accessed February 22, 2010

Confidence in Distal Locking


Confidence in Distal Locking

The TRIGEN SURESHOT Distal Targeting System increases accuracy while reducing radiation associated with distal locking.

Increased fluroscopy times 8 in humeral fracture cases can mean increased radiation exposure. With the TRIGEN SURESHOT Distal Targeting System, you can take full control:

  • The first and only virtual real-time imaging system for easier and more accurate procedures 5
  • Continuous real-time visual for correct drill direction and angle
  • Computer-based calibrated software for perfect circle targeting
  • Fluoroscopy-free during distal locking for reduced radiation exposure

References:
1. Perlmutter GS. Axillary nerve injury. Clinical orthopaedics and related research. 1999 Nov;(368):28-36.
2. Blum J, Rommens PM. Proximal interlocking of humeral intramedullary nails and risk of axillary nerve injury. Der Unfallchirurg. 2002 Jan;105(1):9-13.
3. Nijs S, Sermon A, Broos P. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study Patient Safety in Surgery. V.2: 2008.
4. Baltov AG, Tzachev NN, Tivchev NP, Iotov, AM. Operative treatment of humeral shaft fracture - interlocking nailing versus plating. European Federation of National Orthopaedics and Traumatology (8th Congress). Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue SUPP_1, 180.
5. Tornetta P, Patel P, Tseng S, Whitten A, Ricci W. Distal locking using an electromagnetic field guided computer based real time system. Poster presented at: Annual Meeting of the Orthopaedic Trauma Association; October 8-10, 2009; San Diego, CA
6. Center for Devices and Radiological Health, US Food and Drug Administration. Initiative to reduce unnecessary radiation exposure from medical imaging. http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/ RadiationDoseReduction/ucm199994.htm. Updated February 16, 2010. Accessed February 22, 2010.
7. Klein LW, Miller DL, Balter S, et al. Occupational health hazards in the interventional laboratory: time for a safer environment. Catheter Cardiovasc Interv. 2009;73(3):432-438.
8. Kraus R, Meyer C, Stahl JP, Schnettler R. Intraoperative radiation exposure in elastic stable intramedullary nailing (ESIN) during the growth period. Observations in 162 long bone shaft fractures. Unfallchirurg. 2007 Jan;110(1):28-32.
9. Sont WN, Zielinski JM, Ashmore JP, et al. First analysis of cancer incidence and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 2001;153(4):309-318.
10. Ashmore JP, Krewski D, Zielinski JM, Jiang H, Semenciw R, Band PR. First analysis of mortality and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 1998;148(6):564-574.
11. National Council on Radiation Protection and Measurements. The application of ALARA for occupational exposures. NCRP Statement No. 8. Issued June 8, 1999. http://www.ncrponline/. org/Publications/Statement_8.pdf. Accessed February 22, 2010

Confidence in Radiation Reduction


Confidence in Radiation Reduction

A significant dose response causes increased risks

For each rad of radiation exposure a surgeon recieves in a lifetime, risks increase


risk of all cancers 9 risk of circulatory diseases 10 risk of cancer death 10

 

 

References:
1. Perlmutter GS. Axillary nerve injury. Clinical orthopaedics and related research. 1999 Nov;(368):28-36.
2. Blum J, Rommens PM. Proximal interlocking of humeral intramedullary nails and risk of axillary nerve injury. Der Unfallchirurg. 2002 Jan;105(1):9-13.
3. Nijs S, Sermon A, Broos P. Intramedullary fixation of proximal humerus fractures: do locking bolts endanger the axillary nerve or the ascending branch of the anterior circumflex artery? A cadaveric study Patient Safety in Surgery. V.2: 2008.
4. Baltov AG, Tzachev NN, Tivchev NP, Iotov, AM. Operative treatment of humeral shaft fracture - interlocking nailing versus plating. European Federation of National Orthopaedics and Traumatology (8th Congress). Journal of Bone and Joint Surgery - British Volume, Vol 91-B, Issue SUPP_1, 180.
5. Tornetta P, Patel P, Tseng S, Whitten A, Ricci W. Distal locking using an electromagnetic field guided computer based real time system. Poster presented at: Annual Meeting of the Orthopaedic Trauma Association; October 8-10, 2009; San Diego, CA
6. Center for Devices and Radiological Health, US Food and Drug Administration. Initiative to reduce unnecessary radiation exposure from medical imaging. http://www.fda.gov/Radiation-EmittingProducts/RadiationSafety/ RadiationDoseReduction/ucm199994.htm. Updated February 16, 2010. Accessed February 22, 2010.
7. Klein LW, Miller DL, Balter S, et al. Occupational health hazards in the interventional laboratory: time for a safer environment. Catheter Cardiovasc Interv. 2009;73(3):432-438.
8. Kraus R, Meyer C, Stahl JP, Schnettler R. Intraoperative radiation exposure in elastic stable intramedullary nailing (ESIN) during the growth period. Observations in 162 long bone shaft fractures. Unfallchirurg. 2007 Jan;110(1):28-32.
9. Sont WN, Zielinski JM, Ashmore JP, et al. First analysis of cancer incidence and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 2001;153(4):309-318.
10. Ashmore JP, Krewski D, Zielinski JM, Jiang H, Semenciw R, Band PR. First analysis of mortality and occupational radiation exposure based on the National Dose Registry of Canada. Am J Epidemiol. 1998;148(6):564-574.
11. National Council on Radiation Protection and Measurements. The application of ALARA for occupational exposures. NCRP Statement No. 8. Issued June 8, 1999. http://www.ncrponline/. org/Publications/Statement_8.pdf. Accessed February 22, 2010

Additional Information


A humeral nailing solution you can be confident in

Click on the colored dots to display more information about the design features.

Everything-from the nail profile to the instrument tray-was created to make your case more successful for you and your patient.

One intrument tray includes everything you need for the procedure.

Included in the tray
• Implant removal instruments - No extra set required
• SURESHOT Humeral Tray Caddy - Fits right into tray