Rotator Cuff-sparing Approach for Antegrade Humeral Nailing with Biceps Tenodesis: a Technical Trick with Clinical Implications Academic Article uri icon


MeSH Major

  • Fracture Fixation, Intramedullary
  • Hamstring Tendons
  • Humeral Fractures
  • Organ Sparing Treatments
  • Rotator Cuff Injuries
  • Tenodesis


  • Antegrade intramedullary nails are an established, effective method of fixation for humeral shaft fractures. One significant limitation of this technique is chronic post-operative shoulder pain, which is likely related to the standard approach that involves splitting the rotator cuff to gain access to the nail starting point. Furthermore, mounting evidence suggests that both the intra-articular portion of the biceps tendon and the extra-articular portion in the bicipital groove can scar down after trauma, causing pain and limiting shoulder range-of-motion. We describe an approach through the rotator interval with tenodesis of the biceps tendon and resection of the intra-articular portion. Utilizing a rotator cuff interval instead of a rotator cuff insertion approach allows access to the optimal humeral nail starting point while avoiding damage to intra-articular structures of the shoulder, potentially decreasing sources of post-operative shoulder pain.

publication date

  • August 23, 2016



  • Academic Article



  • eng

Digital Object Identifier (DOI)

  • 10.1097/BOT.0000000000000684

PubMed ID

  • 27580320