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Journal of Orthopaedic Surgery and Research

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Open Access 01-12-2017 | Review

Current concepts in locking plate fixation of proximal humerus fractures

Authors: Christoph J. Laux, Florian Grubhofer, Clément M. L. Werner, Hans-Peter Simmen, Georg Osterhoff

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

Abstract

Despite numerous available treatment strategies, the management of complex proximal humeral fractures remains demanding. Impaired bone quality and considerable comorbidities pose special challenges in the growing aging population. Complications after operative treatment are frequent, in particular loss of reduction with varus malalignment and subsequent screw cutout. Locking plate fixation has become a standard in stabilizing these fractures, but surgical revision rates of up to 25% stagnate at high levels. Therefore, it seems of utmost importance to select the right treatment for the right patient. This article provides an overview of available classification systems, indications for operative treatment, important pathoanatomic principles, and latest surgical strategies in locking plate fixation. The importance of correct reduction of the medial cortices, the use of calcar screws, augmentation with bone cement, double-plate fixation, and auxiliary intramedullary bone graft stabilization are discussed in detail.

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Title: Current concepts in locking plate fixation of proximal humerus fractures
Authors: Christoph J. Laux
Florian Grubhofer
Clément M. L. Werner
Hans-Peter Simmen
Georg Osterhoff
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/s13018-017-0639-3

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Current concepts in locking plate fixation of proximal humerus fractures

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