TELEGRAPH EVOLUTION is a cannulated and lateralized titanium nail. The proximal part is locked by 4 self-tapping screws in 4 different plans.

In case of porotic bone, a washer can be used.

The instrumentation set is compact and the technique reproducible espacially with the specifique distal guide.

Two versions:
– short nail for proximal humerus fractures,
– long nail for mid-shaft fractures.


TELEGRAPH EVOLUTION is a device used for proximal and/or mid-shaft humeral fractures.

The nail is available in short and long versions, in different diameters and lengths.

Because of its linear shape and small diameter, it can be anterograde implanted through the rotator cuff.


Tuberosities fixation in 4 plans with 4 screws. In case of porotic bone, a washer can be used on each proximal screw in order to optimize compression of the bone fragment and/or to allow the tuberosities sutures.


Static or dynamic fixation of the diaphysis by a distal screw and a slotted hole. Dynamic fixation is recommended by designers.


This nail can be used with several techniques to treat 2- and 3-fragment fractures:
– percutaneous for extra-articular fractures,
– standard for valgus-impacted intra-articular fractures,
– optional for non-impacted or even dislocated 3- and 4-fragment fractures when a prosthesis is feasible.


Its primary diameter (7 mm) makes it one of the thinnest nails on the market.
It has an assisted distal locking feature and can either be used in a static or elastic configuration. Its designing surgeons strongly recommend elastic distal locking.


– Intra-articular fracture
– 2- and 3-fragment extra-articular fracture
– Mid-shaft fracture



– Available in 4 diameters: 7, 8, 9 and 10 mm. The range has a proximal diameter of 9 mm, except for the 10 mm nails (10 mm proximally and distally),
– Length: 150 mm,
– Anodized titanium alloy (Ti6AI14V),
– A washer in anodized titanium alloy (Ti6A14V) can be used in case of porotic bone.


– Available in 4 diameters: 7, 8, 9 and 10 mm. The range has a proximal diameter of 9 mm for 7, 8 or 9 mm nails, and 10 mm for 10 mm nail,
– Anodized titanium alloy (Ti6A14V),
– Lengths: 210, 230, 250, 270 and 290 mm (in option),
– A washer in anodized titanium alloy (Ti6A14V) can be used in case of porotic bone.


– New design,
– Anodized titanium alloy (Ti6A14V),
– Ø4 for proximal and distal screws,
– Proximal: from 25 to 55 mm,
– Distal: from 20 à 32 mm.


– Internal diameter: 4 mm,
– External diameter: 11 mm,
– Holes Ø1,8 mm,
– Anodized titanium alloy (Ti6A14V).



  1. Jayankura, M., et al., [Treatment of severe proximal humeral fractures by proximal nailing (Telegraph). A prospective preliminary study]. Rev Med Brux, 2011. 32(6 Suppl): p. S58-65.
  2. Russo, R., et al., Telegraph antegrade nailing in the treatment of humeral fractures with rotator interval split technique. Chir Organi Mov, 2009. 93 Suppl 1: p. S7-14.
  3. Cuny, C., et al., The Telegraph nail for proximal humeral fractures: a prospective four-year study. J Shoulder Elbow Surg, 2008. 17(4): p. 539-45
  4. Cuny, C., et al., [The long Telegraph nail for humeral fractures]. Rev Chir Orthop Reparatrice Appar Mot, 2007. 93(6): p. 564-70.
  5. Boughebri, O., et al., [Treatment of proximal humeral fractures by Telegraph nail: prospective study of 34 cases]. Rev Chir Orthop Reparatrice Appar Mot, 2007. 93(4): p. 325-32.
  6. Cuny, C., et al., [Proximal 4-part humerus fractures treated by antegrade nailing with self-stabilizing screws: 31 cases]. Rev Chir Orthop Reparatrice Appar Mot, 2003. 89(6): p. 507-14.
  7. Cuny, C., et al., [A new locking nail for proximal humerus fractures: the Telegraph nail, technique and preliminary results]. Rev Chir Orthop Reparatrice Appar Mot, 2002. 88(1): p. 62-7.
  8. Cuny, C., et al., Telegraph nail used for internal fixation of proximal humerus fracture. European Journal of Orthopaedic Surgery & Traumatology, 2000. 10(1): p. 21-26.


  1. Dib, C., C. Maroun, and P. Valenti, Nailing technique for proximal humerus fractures. PISC 2017 – Current concepts on shoulder arthroplasty, 2017: p. p.21-23. (pas de publies retrouvées)
  2. Garret, J., et al., Surgical treatment of complex proximal humeral fractures with a technique of nail and osteosuture: « NOS ». Eur J Orthop Surg Traumatol, 2017. 27(3): p. 391-397.
  3. Karabila, M.A., et al., [The role of short Telegraph nail in the treatment of fractures of the upper end of the humerus: about 19 cases]. Pan Afr Med J, 2016. 24: p. 36.
  4. Milin, L., et al., Comparison of modified Hackethal bundle nailing versus anterograde nailing for fixation of surgical neck fractures of the humerus: Retrospective study of 105 cases. Orthop Traumatol Surg Res, 2014. 100(3): p. 265-70.
  5. Cuny, C., et al., Antegrade nailing evolution for proximal humeral fractures, the Telegraph IV: a study of 67 patients. Eur J Orthop Surg Traumatol, 2014.
  6. Thomazeau, H., et al., Is it worth fixing proximal humeral fractures at increased vascular risk?Orthop Traumatol Surg Res, 2012. 98(4): p. 383-9.


Studies and publication ongoing….

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