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The plate fixation strategy of complex proximal humeral fractures

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Abstract

Purpose

For complex proximal humeral fractures, severe displacement and comminuted fragments lead to poor clinical outcomes. Despite considerable management, the locking plate fixation is still a preference and the proper selection of its strategy for each individual seems to be essential.

Method

The available classification system of the fracture, determination of surgical intervention, the common complications and related causes, and the latest critical surgical strategies with locking plate fixation were discussed in this review.

Results

The frequent complications with complex proximal humeral fractures after operative treatment present a great challenge to orthopedic surgeons. In order to maintain the stability of locking plate fixation, several options including calcar screw, bone graft, bone cement augmentation, dual plate fixation, and fracture impaction were available for restoration of medial support.

Conclusion

Restoration of medial support seems of importance to provide solid stability and reduced complication for the complex fractures with fixation of locking plates.

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Funding

This work was supported by Shanghai Science and Technology Commission (19411963100).

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  1. Qi Sun and Xiaoming Wu contributed equally to this work.

Authors and Affiliations

  1. Department of Orthopaedics, Shanghai Tenth People’s Hospital, Tongji University, School of Medicine, Shanghai, 200072, China

    Qi Sun & Ming Cai

  2. Department of Orthopedics, Shanghai First People’s Hospital, Shanghai Jiao Tong University, Shanghai, 200080, China

    Xiaoming Wu

  3. Department of Orthopedics, Shanghai Institute of Traumatology and Orthopedics, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200025, China

    Lei Wang

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  1. Qi Sun
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Sun, Q., Wu, X., Wang, L. et al. The plate fixation strategy of complex proximal humeral fractures. International Orthopaedics (SICOT) 44, 1785–1795 (2020). https://doi.org/10.1007/s00264-020-04544-7

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