PHILOS plate fixation with polymethyl methacrylate cement augmentation of an osteoporotic proximal humerus fracture

Abstract

PHILOS plate fixation in osteoporotic proximal humerus fracture of old age is well-known for high complication rate, especially metal failure, providing various augmentation techniques, such as calcium phosphate cement, allogenous or autologous bone graft. We report a case of PMMA augmentation to provide appropriate reduction with a significant mechanical support. This can be a treatment option for displaced unstable osteoporotic proximal humerus fracture with marked bony defect.

Application of a Lateral Intertubercular Sulcus Plate in the Treatment of Proximal Humeral Fractures: a Finite Element Analysis and Example in Clinical Practice

“…A comparative study by Shen et al [17] reported that placement of the medial support screw greatly reduced the screw cutting, varus deformity, and the probability of secondary surgery. Various methods are used to compensate for the effect of the medial support screw and strengthen medial support in clinical practice, such as autologous or allogeneic fibula implantation, titanium mesh implantation, and the use of an auxiliary steel plate [7][8][9][10][11]. The selection, treatment, and placement of fibula grafts and titanium mesh require high technical experience among orthopedic doctors.…”

“…There are several methods for strengthening medial support in clinical practice, such as allograft fibula implantation [7], titanium mesh implantation [8], bone cement [9], and auxiliary support plates [10][11]. In clinical practice, the authors have used a 1/3 tubular steel plate as an auxiliary plate to develop the shape according to the lateral anatomical structure of the internodal sulcus, placing it on the outside of the internodal sulcus.…”

Application of a lateral intertubercular sulcus plate in the treatment of proximal humeral fractures: A finite element analysis and example in clinical practice

“…A comparative study by Shen et al [17] reported that placement of the medial support screw greatly reduced screw cutting, varus deformity, and the probability of a secondary surgery. In clinical practice, various methods such as autologous or allogeneic fibula implantation, titanium mesh implantation, and the use of an auxiliary steel plate are used to compensate for the effect of the medial support screw and strengthen medial support [7][8][9][10][11].…”

“…In clinical practice, several methods, such as allograft fibula implantation [7], titanium mesh implantation [8], bone cement [9], and auxiliary support plates [10][11], are used for strengthening the medial support. Authors have used a 1/3 tubular steel plate as an auxiliary plate to develop a shape according to the lateral anatomical structure of the internodal sulcus, placing the plate on the exterior of the internodal sulcus.…”

Application of a lateral intertubercular sulcus plate in the treatment of proximal humeral fractures: a finite element analysis

“…In clinical practice, several methods are used to strengthen medial support, such as allograft fibula implantation [ 7 ], titanium mesh implantation [ 8 ], bone cement [ 9 ], and additional steel plate support plates [ 10 , 11 ]. Using a 1/3 tubular steel plate as an additional steel plate shaped according to the lateral anatomical structure of the intertubercular sulcus, the authors have developed a method in which the plate is placed on the lateral of the intertubercular sulcus.…”