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International Orthopaedics
Published in: International Orthopaedics 10/2014

01-10-2014 | Original Paper

Proximal humeral fractures: an understanding of the ideal plate positioning

Authors: Pedro José Labronici, Rodrigo Pires e Albuquerque, Vinícius Schott, Robinson Esteves Santos Pires, Willian Dias Belangero, José Sérgio Franco

Published in: International Orthopaedics | Issue 10/2014

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Abstract

Purpose

The present study aims to evaluate if the bicipital groove can be used as a parameter for ideal plate positioning in proximal humeral fixation applying locking compression plate.

Method

The authors questioned whether the bicipital groove can be used as a parameter for ideal plate positioning applying locking compression plate for proximal humeral fractures. A method using the bicipital groove as the main parameter was developed using computed tomography scan (CT-scan). Seventy shoulders presenting fracture absence were used to calculate proper plate positioning, allowing the largest area for locked screw placement into the humeral head. Intraclass correlation coefficient and Bland and Altman graphics calculated intra-observer reliability for CT-scan evaluation.

Results

All observers presented satisfactory plate positioning using this method. The mean differences for observers were close to zero, suggesting high interobserver reproducibility. A significant (p <0.0001) intra-observer agreement existed for the three evaluators. Observer 2 agreement was the strongest (ICC = 0.98), showing almost perfect reproducibility measurement, followed by observer 3 (ICC = 0.84) with good reproducibility, and lastly observer 1 demonstrated moderate degree agreement (ICC = 0.47).

Conclusion

Considering the CT-scan analysis, the bicipital groove can be used as a parameter for ideal plate positioning in proximal humeral fractures. This method demonstrated satisfactory intra-observer reproducibility. Adopting this method, longer and better distributed screw placement provides more stable fixation for proximal humeral fractures.

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Metadata
Title
Proximal humeral fractures: an understanding of the ideal plate positioning
Authors
Pedro José Labronici
Rodrigo Pires e Albuquerque
Vinícius Schott
Robinson Esteves Santos Pires
Willian Dias Belangero
José Sérgio Franco
Publication date
01-10-2014
Publisher
Springer Berlin Heidelberg
Published in
International Orthopaedics / Issue 10/2014
Print ISSN: 0341-2695
Electronic ISSN: 1432-5195
DOI
https://doi.org/10.1007/s00264-014-2463-2

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