Fig. 4From: Technique and clinical results of a new intramedullary support nail and plate system for fixation of 3- or 4- part proximal humeral fractures in older adultsSteps of ISN fixation. A Insertion of the ISN into the medullary canal through the lateral fracture window. B Insertion of a hemostatic forceps between the ISN and lateral shaft to centralize the ISN as well as subsequent drilling of a guide pin towards the center of the humeral head. C Screwing of the cannulated lag screw along the guide pin. D Percutaneous screwing of the ISN interlocking screwsBack to article page