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Journal of Orthopaedic Surgery and Research
Published in: Journal of Orthopaedic Surgery and Research 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Yu He, Yaoshen Zhang, Yan Wang, Dongsheng Zhou, Fu Wang

Published in: Journal of Orthopaedic Surgery and Research | Issue 1/2017

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Abstract

Background

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).

Methods

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.

Results

The LPMP group showed significantly greater integral and regional construct stiffness, and endured less von Mises stresses, than the other three fixation methods. The stresses on the lateral locking plate were dispersed by the MLP. The LPMP group showed the least change in NSA.

Conclusions

From the finite element viewpoint, the LPMP method provided both lateral and medial direct support. The LPMP system was effective in treating proximal humeral fracture with an unstable medial column.
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Metadata
Title
Biomechanical evaluation of a novel dualplate fixation method for proximal humeral fractures without medial support
Authors
Yu He
Yaoshen Zhang
Yan Wang
Dongsheng Zhou
Fu Wang
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Journal of Orthopaedic Surgery and Research / Issue 1/2017
Electronic ISSN: 1749-799X
DOI
https://doi.org/10.1186/s13018-017-0573-4

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