Introduction: The FIXION® IM HUMERUS and FIXION®IL HUMERUS are expandable intramedullary nails, designed for humeral fractures. We present our results with this new type of intramedullary nailing system.

Materials and Methods: The FIXION® HUMERUS NAILING SYSTEM consists of an expandable nail. Once in position, the nail expands by inflation of saline under controlled pressure.

The FIXION® IM HUMERUS nail is inserted without reaming and no interlocking screws are required, thus reducing x-ray exposure both of operating room staff and patients as well as reducing operation time.

The FIXION® IL HUMERUS included the option for proximal interlocking screws and is designed for proximal or distal humeral fractures.

Results: We have used the system to stabilize humeral fractures with 53 patients since May 2002. Postoperative radiographic evaluation demonstrated correct axial alignment in all cases. Until now, our patients have made a satisfactory recovery with early pain-free mobilisation. Good callus formation was noted about 10 weeks after the procedure.

As complications we also saw 3 non unions with the FIXION® IM HUMERUS, no infections or radial nerve injuries and no adverse events after the revision of the non unions to a FIXION® IL HUMERUS.

Conclusion: The FIXION® HUMERAL NAILING SYSTEM offers an innovative and effective device for minimally invasive and biological surgery with substantially less O.R. and fluoroscopy times, with a low rate of complications.

Purpose of the study: To evaluate the efficacy and safety of a novel intramedullary, expandable and self-locking system for stabilization of proximal femoral fractures.

Patients and methods: Since October 2001, Fixion ® PF Nails have been implanted in 112 patients (84f / 28m) with mean age of 76.4 years (40–97). Ninety patients were operated for intertrochanteric fractures, and 22 for subtrochanteric fractures. The system consists of a diaphyseal nail and a femoral head peg. The nail is an expandable tube that, once inserted (unreamed) into the medullary canal, expands by 60%, using saline solution under controlled pressure. The expansion causes abutment of the nail longitudinal bars to the inner surface of the canal, resulting in excellent hold. The hip peg includes an expandable distal end, which, once expanded, condenses the travecular bone and enhances the femoral head grip and rotational stability.

Results: Average operative time was 62; minutes (25–90) and average fluoroscopy exposure 1.44 minutes (0.46–4.26). Perioperative blood loss was negligible. Optimal alignment was restored in all cases. No significant operative problems or complications were reported. Union was demonstrated in all cases within 12 weeks, except for two cases of severe osteoporosis, in which delayed cut-out of the implant was reported.

Conclusions: This minimally invasive procedure, requiring no reaming or use of interlocking screws, is user-friendly, safe, reduces the operative and fluoroscopy time, eliminates the risk of postoperative femoral shaft fracture and provides optimal ultimate outcome.

Since October 2001 we have used the FIXION® proximal femoral (PF) intramedullary nailing system to stabilise 93 proximal femoral fractures, 81 of which were pertrochanteric and 12 subtrochanteric.

Postoperative radiographs showed correct axial alignment in all cases. All patients recovered satisfactorily and mobilised early and without pain. Good callus formation was noted about 10 weeks after the procedure. We compared the use of the FIXION® PF with the use of Gamma nails and noted considerably shorter operation and radiological examination times.