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For
the cuff's advocates we have to refer to
Gaulier's article published in the french
"revue de chirurgie orthopédique"
of May 1999. In the article, Gaulier shows
that the more medial the humeral entrance
point is, the better the crossed cuff is
vascularised and the lesser the damage. In
this respect, the TELEGRAPH nail is the
most medial due to its straightness.

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Noteworthy
is the straightness of the TELEGRAPH nail
and its entrance point corresponding to
the specific point of shoulder prosthesis
fitters. That entrance point is in the
articular area of the head.

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There
are two consequences
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1.
The nail should be pushed in enough not to
affect the articular function. Therefore,
it is essential that it be located under
the articular bony cortical level.
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2.
The arm should be placed in reverse
pushing position to clear that entrance
point, anatomically located at one
centimetre in front or inside of the
antero-external angle of the acromion.
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