Two-Part Surgical Neck Fractures of the Proximal Part of the Humerus<sbt aid="1049903">A Biomechanical Evaluation of Two Fixation Techniques</sbt>

Abstract

The high failure rate in torsion of the proximal humeral nail-bone construct is concerning, and, with relatively osteoporotic bone and early motion, the results could be poor.

The use of a new locking 90° blade plate in the treatment of atrophic proximal humerus nonunions

“…Clinical and radiographic union was achieved in all seven cases without loss of reduction or fixation stability, after an average of 5.85 months (range [4][5][6][7][8]. No patient required additional procedures, nor was there any infection or avascular necrosis.…”

“…The use of locked plates has been found to be biomechanically superior to intramedullary nails [4] and blade plates [25] in stabilising fractures of the surgical neck of the humerus; but, despite recent advances of locked-plate technology, humeral head necrosis, osseous malalignment, nonunion, deep infection, hardware cutthrough, and loss of reduction after open reduction and internal fixation of proximal humerus fractures remain a problem [17,19,26]. In order to decrease these complications and increase the stability in complex metaphyseal nonunions of the proximal humerus associated with bone loss, a small proximal fragment, osteoporosis, and multiple previous operations, we designed a locked 90°blade plate implant, which combines the advantages of the blade plate with those of locking plates.…”

Osteossíntese das fraturas da extremidade proximal do úmero com sistema de placa de ângulo fixo com parafusos bloqueados: técnica e resultados

“…Edwards et al (15) demonstraram também, em estudo cadavérico, que a resistência biomecânica da placa bloqueada, tanto a força de angulação quanto a de torsão, em fraturas cominutas do colo cirúrgico, é maior quando comparada com a da haste intramedular bloqueada.…”

Biomechanical in vitro assessment of fixed angle plating using a new concept of locking for the treatment of osteoporotic proximal humerus fractures

“…The age of the donors ranged between 48 and 95 years with an average age of 79 years. For each specimen anthropometric measurements of the total length (head to distal condyles), head circumference, and metaphyseal shaft circumference were made [18]. Radiographs of each bone were taken to ensure a healthy bone.…”