The Relationship of Proximal Locking Screws to the Axillary Nerve During Antegrade Humeral Nail Insertion of Four Commercially Available Implants

Abstract

Nail SS's oblique locking screw may injure the ascending branch of the axillary nerve. Three of the 4 nails tested did not endanger the axillary nerve. However, when transverse proximal locking screws are inserted from a lateral-to-medial direction, they may endanger an arborized axillary nerve. Blunt dissection should be performed with a visible path to bone before instrumentation to reduce the risk of axillary nerve injury.