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Related Experiment Video

Updated: May 29, 2025

An Intramedullary Locking Nail for Standardized Fixation of Femur Osteotomies to Analyze Normal and Defective Bone Healing in Mice

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Does the Proximal Humerus Nail with 2 Distal Screws Provide Sufficient Rotational Stability?

Ki Yong An¹, Tae Gyu Park¹, Min Young Kim¹

¹Department of Orthopedic Surgery, Kwangju Christian Hospital, Gwangju, Korea.

Clinics in Orthopedic Surgery

|February 6, 2025

Summary

Using two distal screws for proximal humerus nails provides adequate rotational stability for fracture fixation. This approach may reduce surgical time and radiation exposure without compromising patient outcomes.

Keywords:

Finite element analysis Fracture Humerus Intramedullary nail Proximal humerus fracture

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Published on: March 3, 2023

Area of Science:

Orthopedic surgery
Biomechanical engineering
Medical device analysis

Background:

Proximal humerus fractures are commonly treated with intramedullary nails.
Optimal distal screw configuration for these nails remains under-researarched.
Understanding screw placement impact on stability is crucial for surgical decision-making.

Purpose of the Study:

To evaluate the biomechanical stability of different distal screw configurations in proximal humerus nails.
To analyze stress distribution in bone and implant for various screw placements.
To compare screw configurations in both normal and osteoporotic bone models.

Main Methods:

Finite element analysis (FEA) was performed on a humerus model with a TDM nail.
Three groups were tested: 3 distal screws, 2 screws (dynamic & proximal static), and 2 screws (dynamic & distal static).
Stress distributions and von Mises stress were computed for each configuration and bone density.

Main Results:

All tested screw configurations demonstrated sufficient rotational stability.
No configurations reached bone or implant failure strength.
Using two screws did not compromise stability, even in osteoporotic bone models.

Conclusions:

Distal fixation with two screws in proximal humerus nails is biomechanically sound.
This configuration offers comparable stability to using three screws.
Reduced screw usage may lead to decreased surgical time and radiation exposure.