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.
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