Intramedullary Plating of Complex Proximal Humerus Fractures: A Case Series - Letter to Editor

Articles in Press

Document Type : LETTER TO THE EDITOR

Authors

Department of Shoulder and Elbow Surgery, Center for Orthopedic Surgery, The Third Affiliated Hospital of Southern Medical University, 183 Zhongshan Avenue West, Guangzhou 510630, China

10.22038/abjs.2024.81804.3727

Abstract

Abstract: We commend McDonald et al. for their innovative technique using intramedullary plating for complex proximal humerus fractures, particularly addressing the challenge of calcar comminution. Our approach, using an anterior deltoid split, contrasts with the deltopectoral method, offering enhanced lateral exposure and minimizing vascular disruption, thus facilitating fracture reduction. The displaced tuberosities allow for direct visualization, enabling secure intramedullary plate placement. Emphasizing robust humeral head support, we advocate for both proximal and distal plate fixation to maintain the neck-shaft angle during early rehabilitation. In elderly or osteoporotic patients, combining an intramedullary plate with allograft bone grafting significantly improves fracture stability and union rates, aligning with established biomechanical principles. This approach, supported by previous studies, underscores the efficacy of comprehensive fixation strategies in managing complex proximal humerus fractures.

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The Archives of Bone and Joint Surgery

Articles in Press, Accepted Manuscript
Available Online from 15 September 2024

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History

  • Receive Date: 24 August 2024
  • Revise Date: 27 September 2024
  • Accept Date: 07 September 2024

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