Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures
Abstract Background The lateral locking plate for the proximal humerus is currently the most commonly used surgical procedure for the treatment of elderly proximal humeral comminuted fractures. Previous studies have found that the rate of postoperative complications in patients of proximal humerus f...
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BMC
2024-12-01
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| Series: | BMC Musculoskeletal Disorders |
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| Online Access: | https://doi.org/10.1186/s12891-024-08216-0 |
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| author | Bangjun Cheng Xiping Jiang Xiaofeng Zhang Shixin Guo Qi Chen Shengchao Du Yi Luo Yaohua He |
| author_facet | Bangjun Cheng Xiping Jiang Xiaofeng Zhang Shixin Guo Qi Chen Shengchao Du Yi Luo Yaohua He |
| author_sort | Bangjun Cheng |
| collection | DOAJ |
| description | Abstract Background The lateral locking plate for the proximal humerus is currently the most commonly used surgical procedure for the treatment of elderly proximal humeral comminuted fractures. Previous studies have found that the rate of postoperative complications in patients of proximal humerus fractures with medial column involvement is relatively high. Through biomechanical methods, this study aims to investigate the effectiveness of the conventional lateral locking plate fixation along with the addition of the metacarpal supporting plate on the medial column in the treatment for proximal humeral fractures involving the medial column. The goal is to reduce the rate of postoperative internal fixation failure in patients with medial column injury. Methods Thirty artificial synthetic humerus models are used as experimental samples. A proximal humerus fracture model with medial column injury was created, and then divided into two groups. Group A was fixed with a proximal humerus lateral locking plate (single-plate group). Group B was fixed with a proximal humerus lateral locking plate and a metacarpal supporting plate on the medial column (double-plate group). The failure displacement, stiffness, and strength of the repaired proximal humerus fractures with two different methods were tested under compression at posterior extension of 15°, forward flexion of 15°, and vertical direction. Results There was no statistical significance in the comparison of the failure displacement of repaired proximal humeral fractures between the two groups under compression at posterior extension of 15° and forward flexion of 15° (P > 0.05). However, the failure displacement of the fracture was longer in single-plate group than in double-plate group under compression at vertical direction (P < 0.05). The double-plate group was better in terms of biomechanical stiffness and strength compared to the single-plate group at all three testing angles (P < 0.05). Conclusions For patients whose proximal humeral fractures involve the medial column, the addition of a support plate on the medial side of the humerus is recommended along with the lateral locking plate. The double-plate strategy can increase the stability of the medial column of the proximal humerus, and enhance the overall biomechanical property of the repaired proximal humerus. |
| format | Article |
| id | doaj-art-035028ccc61b43df9de1d3339d4b6e4d |
| institution | Kabale University |
| issn | 1471-2474 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Musculoskeletal Disorders |
| spelling | doaj-art-035028ccc61b43df9de1d3339d4b6e4d2024-12-29T12:07:52ZengBMCBMC Musculoskeletal Disorders1471-24742024-12-012511610.1186/s12891-024-08216-0Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fracturesBangjun Cheng0Xiping Jiang1Xiaofeng Zhang2Shixin Guo3Qi Chen4Shengchao Du5Yi Luo6Yaohua He7Department of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of MedicineDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalDepartment of Orthopedic Surgery, Shanghai Sixth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Jinshan Branch, Jinshan District Central HospitalAbstract Background The lateral locking plate for the proximal humerus is currently the most commonly used surgical procedure for the treatment of elderly proximal humeral comminuted fractures. Previous studies have found that the rate of postoperative complications in patients of proximal humerus fractures with medial column involvement is relatively high. Through biomechanical methods, this study aims to investigate the effectiveness of the conventional lateral locking plate fixation along with the addition of the metacarpal supporting plate on the medial column in the treatment for proximal humeral fractures involving the medial column. The goal is to reduce the rate of postoperative internal fixation failure in patients with medial column injury. Methods Thirty artificial synthetic humerus models are used as experimental samples. A proximal humerus fracture model with medial column injury was created, and then divided into two groups. Group A was fixed with a proximal humerus lateral locking plate (single-plate group). Group B was fixed with a proximal humerus lateral locking plate and a metacarpal supporting plate on the medial column (double-plate group). The failure displacement, stiffness, and strength of the repaired proximal humerus fractures with two different methods were tested under compression at posterior extension of 15°, forward flexion of 15°, and vertical direction. Results There was no statistical significance in the comparison of the failure displacement of repaired proximal humeral fractures between the two groups under compression at posterior extension of 15° and forward flexion of 15° (P > 0.05). However, the failure displacement of the fracture was longer in single-plate group than in double-plate group under compression at vertical direction (P < 0.05). The double-plate group was better in terms of biomechanical stiffness and strength compared to the single-plate group at all three testing angles (P < 0.05). Conclusions For patients whose proximal humeral fractures involve the medial column, the addition of a support plate on the medial side of the humerus is recommended along with the lateral locking plate. The double-plate strategy can increase the stability of the medial column of the proximal humerus, and enhance the overall biomechanical property of the repaired proximal humerus.https://doi.org/10.1186/s12891-024-08216-0Proximal humeral fracturesBiomechanical propertyLateral locking plateMetacarpal supporting plate |
| spellingShingle | Bangjun Cheng Xiping Jiang Xiaofeng Zhang Shixin Guo Qi Chen Shengchao Du Yi Luo Yaohua He Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures BMC Musculoskeletal Disorders Proximal humeral fractures Biomechanical property Lateral locking plate Metacarpal supporting plate |
| title | Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures |
| title_full | Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures |
| title_fullStr | Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures |
| title_full_unstemmed | Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures |
| title_short | Biomechanical study of two different fixation methods for the treatment of Neer III proximal humerus fractures |
| title_sort | biomechanical study of two different fixation methods for the treatment of neer iii proximal humerus fractures |
| topic | Proximal humeral fractures Biomechanical property Lateral locking plate Metacarpal supporting plate |
| url | https://doi.org/10.1186/s12891-024-08216-0 |
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