Background Inversion deformities caused by insufficient medial support are especially common when the PHILOS locking plate is used to treat proximal humeral fractures. Using finite element analysis, we aimed to compare the biomechanical properties of a PHILOS locking plate (PLP) and a PLP combined with a lateral intertubercular sulcus plate (PLP-LSP) in the fixation of proximal humeral fractures with loss of the medial column. Methods After creating a three-dimensional finite element model of a proximal humeral fracture with loss of the medial column, three implant models were established. A full-screw PLP was used in Group A, a PHILOS plate lacking medial screw support and an additional steel plate (MPLP-LSP) were used in Group B, and a full-screw PLP-LSP was used in Group C. The three fixation models were applied to the proximal humeral fracture model, following which horizontal, compressive, and rotational loads were applied to the humerus model. We evaluated structural stiffness and stress distribution in the implant and compared displacement and angle changes among the three models. Results Displacement and angle changes were smallest in Group C (PLP-LSP). The implant model used in Group C also exhibited greater structural rigidity, endured less von Mises stress, and was more stable than the models used in Group A and Group B. Conclusion An LSP placed at the intertubercular sulcus provides effective lateral and medial support, thereby reducing stress on the PLP and providing better stability with proximal humeral fractures.
Background: Inversion deformities caused by insufficient medial support are especially common when the PHILOS locking plate is used to treat proximal humeral fractures. Using finite element analysis, the present study aimed to compare the biomechanical properties of a PHILOS locking plate (PLP) and a PLP combined with a lateral intertubercular sulcus plate (PLP-LSP) in the fixation of proximal humeral fractures with loss of the medial column. We also present the results of a 69-year-old female patient with a comminuted fracture of the proximal right humerus (Neer type four-part fracture) who underwent successful surgical treatment with a PHILOS plate combined with an auxiliary lateral intertubercular sulcus plate. Methods: After creating a three-dimensional finite element model of a proximal humeral fracture with loss of the medial column, three implant models were established. A full-screw PLP was used in Group A, a PHILOS plate lacking medial screw support and an auxiliary plate (MPLP-LSP) was used in Group B, and a full-screw PLP-LSP was used in Group C. The three fixation models were applied to the proximal humeral fracture model, following which horizontal, compressive, and rotational loads were applied to the humerus model. We evaluated structural stiffness and stress distribution of the implant and compared displacement and angle changes among the three models. Results: Displacement and angle changes were smallest in Group C (PLP-LSP) compared to those in Group A and Group B. The implant model used in Group C also showed the highest structural rigidity, endured less von Misses stress, and had the strongest stability than that used in Group A and Group B. Conclusion: An LSP placed at the internodal grove not only aids in anatomical reduction but also provides effective lateral and medial support, thereby reducing stress on the PLP and providing better stability in patients with proximal humeral fractures.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.