Epinail-Elbow nail allows for immediate elbow range of motion
By Carolyn Rogers
According to poster exhibit P475, the Epinail-Elbow nail enables anatomic reduction of fracture fragments and eliminates the need for a post-operative immobilization—allowing for immediate active and assisted elbow range of motion. The study also indicates that this new osteosynthesis method for treating fractures of the proximal ulna dramatically reduces the number of complications usually encountered with previous fixation implants.
Although treatment strategies for proximal ulna fractures are determined by several clinical and biomechanical factors, treatment is always aimed at obtaining a stable osteosynthesis so that early elbow joint mobilization may be achieved. To assess the effectiveness of the intramedullary Epinail-Elbow locked nail—recently developed in Italy—researchers used the implant on 200 fractures of the proximal third of the ulna at 11 institutions throughout Italy.
The Epinail-Elbow nail is a cylindrical, titanium, cannulated nail whose diameter decreases from 6 mm proximal to 5 mm distal. The nail has five holes for the distal locking screws, and a washer is used to achieve proximal compression.
In all 200 cases treated in the study, consolidation of the fracture was obtained by closed introduction of the Epinail-Elbow nail. The only intra-operative complication was the rupture of a reamer for the distal screws; no postoperative fractures or nonunions were encountered. During the postoperative period, two nails broke down, but the fractures healed uneventfully.
The researchers conclude that this new osteosynthesis method for treating fractures of the proximal ulna allows surgeons to avoid many of the usual complications encountered with previous fixation implants. This intramedullary nail, although introduced by closed technique, enables anatomic reduction of fracture fragments and eliminates the need for postoperative immobilization. In addition to clinical and radiographic recovery, this treatment method allows for immediate active and assisted elbow range of motion, enabling the patient to return to daily activities
The lead researcher for poster exhibit P475 is Fabio Valerio Sciarretta, MD, of Rome, Italy. Additional researchers on the team—also from Italy—include Paolo Zavattini, MD; Antonio Merello, MD; Giovanni Brugo; Ruggero Riva, MD; Sandro Facchinelli, MD; Giuseppe Silvestrin, MD; Franco Togo, MD; and Michele Lisanti, MD. The authors report no conflicts of interest.