Biomechanical evaluation of a novel dualplate fixation method for proximal humeral fractures without medial support

Journal of Orthopaedic Surgery and Research
Yu HeFu Wang

Abstract

Comminuted fractures of the proximal humerus are generally treated with the locking plate system, and clinical results are satisfactory. However, unstable support of the medial column results in varus malunion and screw perforation. We designed a novel medial anatomical locking plate (MLP) to directly support the medial column. Theoretically, the combined application of locking plate and MLP (LPMP) would directly provide strong dual-column stability. We hypothesized that the LPMP could provide greater construct stability than the locking plate alone (LP), locking plate combined with a fibular graft (LPSG), and locking plate combined with a distal radius plate (LPDP). LP, LPMP, LPSG, and LPDP implants were instrumented into the finite element model of a proximal humeral fracture. Axial, shear, and rotational loads were applied to the models under normal and osteoporotic bone conditions. The whole simulation was repeated five times for each fixator. To assess the biomechanical characteristics, the construct stiffness, fracture micromotion, stress distribution, and neck-shaft angle (NSA) were compared. The LPMP group showed significantly greater integral and regional construct stiffness, and endured less von Mises stresses, than t...Continue Reading

References

Mar 5, 2004·Journal of Shoulder and Elbow Surgery·Julie AgelM Bradford Henley
Jan 6, 2006·Clinical Orthopaedics and Related Research·Naeder Helmy, Beat Hintermann
Jan 6, 2006·Clinical Orthopaedics and Related Research·Athanasios KoukakisAlexander Amini
Mar 5, 2008·Journal of Orthopaedic Trauma·Michael J GardnerDean G Lorich
Oct 6, 2009·Journal of Orthopaedic Science : Official Journal of the Japanese Orthopaedic Association·Ivan D MicicIn-Ho Jeon
Dec 24, 2010·Injury·Robert C SproulBrian T Feeley
Apr 16, 2016·Journal of Shoulder and Elbow Surgery·Florian HaastersBen Ockert

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Citations

Jun 13, 2019·Journal of Orthopaedic Trauma·Sam-Guk Park, Young-Jin Ko
Jun 15, 2020·International Orthopaedics·Qi SunMing Cai
Jun 30, 2021·Current Osteoporosis Reports·Gregory S LewisPeter Varga
May 23, 2021·Journal of Shoulder and Elbow Surgery·J Christoph KatthagenBenedikt Schliemann
Aug 15, 2021·The International Journal of Medical Robotics + Computer Assisted Surgery : MRCAS·Matthew JianQiao PengXinXu Li

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Software Mentioned

Abaqus
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