RESEARCH Fixed Angle Plate Fixation in Simulated Humerus Fractures

Numerous devices of fixation for displaced proximal humerus fractures have been described. The most common devices include plate fixation, fixed-angle plate fixation, antegrade intramedullary fixation, tension band wiring, percutaneous fixation, and external fixation. We believe that a more optimal device potentially remains to be discovered.

Through evaluating the strengths and weaknesses of these previously described devices, we attempted to design a novel device and technique. Our efforts resulted in a percutaneously applied, low profile, fixed-angle plate with means to secure tuberosity fragments with tension band suture.

This new experimental design possesses many theoretical design advantages over the previous methods of fixation described for the treatment of displaced proximal humerus fractures. With the use of limited cadaveric model, we were able to demonstrate improvements in biomechanical properties relative to the ASIF T-plate. The differences in biomechanical properties between noncomminuted and comminuted trials reveal the significant role that fracture configuration plays in the fixation. The comminuted fractures, with the T-plate or experimental design exhibited significantly less stiffness and ultimate load before failure and significantly higher values for displacement at physiologic loads.

Published Research: Fixed Angle Plate Fixation in Simulated Fractures of the Proximal Humerus

Published in the Journal Shoulder Elbow Surgery, Vol. 12, Number 6, November/December 2003, pp 578-588

Proximal Humerus Informational Handout

A proximal humerus (shoulder) fracture is a broken bone of the shoulder at the ball (humeral head). This may be a complete or incomplete break. A fracture of the proximal humerus may involve the anatomic neck, surgical neck or one or both of the attachments (tuberosity) of the rotator cuff muscles. Severe fractures, fractures that are displaced (not in appropriate alignment) require surgery to restore and maintain the bone fragments in normal position.

Dr. Chudik works through a limited incision on the front of the shoulder in an interval between the deltoid and pectoral muscles of the shoulder to reposition the bone fragments and fix them in place. During surgery, live X-ray is used to ensure appropriate alignment of all the bone fragments.