engBallesteros-Betancourt, JR.Ríos, M.García-Tarriño, R.Domingo, A.Peidro, Ll.Llusá, M.Anatomic and surgical basis for posteroanterior distal locking of the endomedullary antegrade humeral nailing.ART-2017-147569Recent years have witnessed the increasing use of endomedullary nails in diaphyseal long-bone fractures. These rods have considerably become a significant advance in fracture treatment. However, one of their weak points has been the need to lock them at a distal level at their point of insertion. Since the introduction of these nails, many ideas have been proposed to make their locking easier, to reduce possible iatrogenic neurovascular damage, and surgical and exposure-to-radiation times. In the particular case of the humerus, when the option is antegrade nailing, locking is usually carried out in an anteroposterior direction, with an anterior approach at a distal arm level and a potential associated morbidity including vein damage, traumatic dissection through muscles, and damage to the musculocutaneous nerve. Sometimes locking is carried out in a lateromedial direction with a lateral arm approach at a distal level, also with associated morbidity, including damage to the radial nerve, to the cubital nerve, to veins, and to the humeral and the radial recurrent arteries. The authors of this paper propose, in order to perform the distal locking of humeral antegrade endomedullary nails easier, a posteroanterior distal locking with a minimum posterior percutaneous approach of the arm. The anatomical study of the extremity shows that this technique is the least damaging for muscular and neurovascular structures in the extreme distal end of the arm and, therefore, decreases possible complications; particularly, neurovascular pre- and post-surgical complications. Finally, the authors describe the details of patient positioning to carry out their proposed technique.2017http://zaguan.unizar.es/record/168036http://zaguan.unizar.es/record/168036oai:zaguan.unizar.es:168036International journal of advanced joint reconstruction 4, 2 (2017), 38-45by-nchttps://creativecommons.org/licenses/by-nc/4.0/deed.esinfo:eu-repo/semantics/openAccess