ArticlePloS one2018
Biomechanical evaluation of hybrid double plate osteosynthesis using a locking plate and an inverted third tubular plate for the treatment of proximal humeral fractures.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 28 citations in OpenAlex.
- Double plating is associated with higher fixation strength than single plating in osteoporotic fractures of the scapular spine: a biomechanical study.Archives of orthopaedic and trauma surgery · 2022Trial
- Biocomposite-Based Biomimetic Plate for Alternative Fixation of Proximal Humerus Fractures.Biomimetics (Basel, Switzerland) · 2025Article
- [Proximal humerus fracture: old and new, established and doubtful, conservative and operative aspects].Unfallchirurgie (Heidelberg, Germany) · 2025Review
- "Mother and baby plate": a strategy to improve stability in proximal fractures of the ulna.Archives of orthopaedic and trauma surgery · 2023Article
- Preventing varus collapse in proximal humerus fracture fixation: 90-90 dual plating versus endosteal fibular allograft strut.Archives of orthopaedic and trauma surgery · 2023Article
- Double Plating for Complex Proximal Humeral Fractures: Clinical and Radiological Outcomes.Journal of clinical medicine · 2023Article
- Reduction and fixation of proximal humeral fracture with severe medial instability using a small locking plate.BMC surgery · 2021Article
- [Research progress on medial support augmentation of plate osteosynthesis for proximal humeral fractures].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2021Review
- The plate fixation strategy of complex proximal humeral fractures.International orthopaedics · 2020Review
- Biomechanical behavior of three types of fixation in the two-part proximal humerus fracture without medial cortical support.PloS one · 2019Article
- The comparison of clinical effect, knee function, prognosis of double plate fixation and locking plate internal fixation for tibial plateau fractures.Pakistan journal of medical sciencesArticle
Corrections and comments
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Authors and funding
7 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreating proximal humerus fractures can be challenging because of large metaphyseal defects that conceal anatomical landmarks. In such cases, medial cortical support with, for example, calcar screws, is mandatory. Nevertheless, varus dislocations and implant failures in patients with impaired bone quality persist. Thus, the need for effective treatment of these patients exists. Hybrid double plate osteosynthesis was introduced as an alternative, yielding similar results as calcar screws. However, a biomechanical comparison of the stability of these two techniques is pending.
methodsCadaveric humeral specimens were treated with plate osteosynthesis and calcar screws (group 1, n = 9) or hybrid double plate osteosynthesis (group 2, n = 9) using a proximal humerus fracture model with a two-part fracture. Displacement, stiffness, failure mode, and ultimate load were examined biomechanically in a cyclic compressive-loading scenario.
resultsAlthough the hybrid double plate osteosynthesis (group 2) tended to confer higher stiffnesses than the medial support screws at higher cycles (group 1), this trend was below the level of significance. The displacement revealed non-significantly lower values for group 1 as compared with group 2 for cycles 50 and 2000, but at 5000 cycles, group 2 offered non-significantly lower displacement values than group 1. The ultimate load tended to be non-significantly higher in the hybrid double plate osteosynthesis group (group 2: 1342±369 N, group 1: 855±408 N). Both groups yielded similar failure rates, with the majority of failures in group 2 being gap closures (n = 8), whereas those in group 1 being plate dislocations (n = 4).
conclusionsThe use of an additive plate osteosynthesis in the region of the bicipital groove may be a potential alternative to the previously-established method of using calcar screws. The biomechanical data obtained in this study suggests that hybrid double plate osteosynthesis is as rigid and robust as calcar screws.
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