The bicipital groove as a landmark for reconstruction of complex proximal humeral fractures with hybrid double plate osteosynthesis

Theopold, Jan; Marquaß, Bastian; Fakler, Johannes K. M.; Steinke, Hanno; Josten, Christoph; Hepp, Pierre

doi:10.1186/s12893-016-0125-6

Cited by 27 publications

(28 citation statements)

References 20 publications

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“…The study by Theopold et al describes a technique which combines the classical locking plate with an in-verted anterior third-tubular plate. Here, the bicipital groove is used as an anatomic landmark [29].…”

Section: Proximal Humerusmentioning

confidence: 99%

Biomechanics of Upper Extremity Double Plating

et al. 2019

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Double plating (DP) is an established treatment modality in traumatology. For certain indications, such as open reduction and internal fixation of bicondylar tibial plateau fractures and distal humeral fractures, DP is standard of care in the clinical routine. However, the principles of DP can be transferred to other anatomic regions and indications. In the past years, DP has been brought more and more into focus. For revision cases, such as the treatment of fracture non-unions, DP seems generally useful. In anatomical locations with high torsional stress and bending forces, but also in regions with traction forces by muscles and tendons DP provides multiplanar stability and therefore seems to have biomechanical advantages. Usually two smaller implants can replace one larger implant. Thus, the number of points of fixation can be increased, the stability can be improved and soft-tissue irritations by bulky implants can be minimized. Along with the established indication and application at the distal humerus, there is biomechanical evidence in the current literature for DP of clavicle fractures and humeral shaft fractures. Furthermore, DP provides mechanical advantages in the treatment of certain proximal humeral fractures and olecranon fractures. This review of the literature summarizes the published literature on biomechanics of upper extremity DP.

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Section: Proximal Humerusmentioning

confidence: 99%

Biomechanics of Upper Extremity Double Plating

et al. 2019

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“…These findings stand in contrast to past investigations which compared surgical and non-surgical treatments of Neer class 3 or 4 partial fractures and found no significant differences in treatment outcomes between the two methods. Other studies showed that there were no differences between locking plate and semijoint osteoplasties [22,23].…”

Section: Discussionmentioning

confidence: 95%

The biomechanics of combined lateral and posterior plates for treating proximal humerus fractures with medial column defects

Zhang

Yuechao

Wang

et al. 2020

Preprint

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KEYWORDSproximal humeral fracture, locking plate, internal fixation, biomechanics, finite element analysis 2 Abstract Background. We investigated the therapeutic effects associated with the combined use of lateral and posterior plates for treating complex proximal humerus fractures. Methods. We used in vitro biomechanical experiments and computer three-dimensional finite element analyses to investigate the biomechanical properties of combined lateral and posterior plates when treating proximal humerus fractures. Eighteen left SAWBONE (Pacific Research Labs) humerus bones were randomly divided among three groups. We established a medial column defect model for surgical neck fractures in each bone specimen and achieved fixation using a proximal humerus locking plate. Each of the three groups used a different fixation method. Group A used a Proximal Humerus Internal Locking System (PHILOS) plate support only. Group B used the PHILOS plate with a posterior locking plate (but without medial column support screws). Group C used the PHILOS plate with both the posterior locking plate and medial column support screws. We subjected three sets of specimens to axial compression, torsion, shear compression, model failure, fatigue testing, and micro-strain analyses.Results and conclusions. In vitro biomechanical analysis and three-dimensional finite element analyses showed that the PHILOS plate, in combination with the posterior locking plate and medial column support screws (Group C), had significantly enhanced biomechanical properties when compared with traditional single plate supports.

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“…The only known, currently available clinical work with results after DPO with lateral angle-stable plate and additional anterior plate dates from 2016 by Theopold et al [19]. Seven of ten patients who underwent DPO for complex proximal humerus fractures were clinically evaluated.…”

Section: Proximal Humerusmentioning

confidence: 99%

Clinical Application and Outcomes of Upper Extremity Double Plating

et al. 2019

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Dual plating in fractures of the upper extremity is well established for the distal humerus. The indication for the use of dual plating has been expanded over the last few years. While dual plating was originally frequently used in revisions of non-unions, it is nowadays also used in primary fixation of diverse complex fractures of the upper extremity. The high biomechanical fixation strength of dual plating is advantageous in regions with high bending and torsional stresses, such as the humeral shaft. An additional anterior plate provides high fixation strength and reduces the risk of loss of reduction in complex proximal humeral fractures and allows for direct fixation of lesser tuberosity fragments. Low-profile plates have been introduced for complex proximal ulna fractures. In dual plating the improved mechanical stability is combined with a reduced risk of implant related soft tissue irritations. The present article provides an overview of current indications for dual plating of upper extremity fractures and outlines technical aspects as well as advantages over conventional fixation techniques.

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The bicipital groove as a landmark for reconstruction of complex proximal humeral fractures with hybrid double plate osteosynthesis

Cited by 27 publications

References 20 publications

Biomechanics of Upper Extremity Double Plating

Biomechanics of Upper Extremity Double Plating

The biomechanics of combined lateral and posterior plates for treating proximal humerus fractures with medial column defects

Clinical Application and Outcomes of Upper Extremity Double Plating

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