ArticleArchives of orthopaedic and trauma surgery2022
Evaluation of mushroom-shaped allograft for unstable proximal humerus fractures.
Article in Archives of orthopaedic and trauma surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 7 citations in OpenAlex.
- [Research progress on medial support augmentation techniques 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 · 2026Review
- A biomechanical comparison of fibular strut and femoral head allograft for augmented locking plate fixation in three-part proximal humerus fractures.JSES international · 2026Article
- Progress in the treatment of complex osteoporotic proximal humeral fractures in elderly patients.Frontiers in surgery · 2026Review
- Bone grafting augmentation choices in complex proximal humerus fractures: A systematic review.Journal of orthopaedics · 2025Review
- Treatment of Metaphyseal Defects in Plated Proximal Humerus Fractures with a New Augmentation Technique-A Biomechanical Cadaveric Study.Medicina (Kaunas, Lithuania) · 2023Article
- Standardized fracture creation in the distal humerus and the olecranon for surgical training and biomechanical testing.Archives of orthopaedic and trauma surgery · 2022Article
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Authors and funding
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionProximal humerus fractures are common injuries of the elderly. Different treatment options, depending on fracture complexity and stability, have been recommended in the literature. Particularly for varus displaced fractures with a lack of medial support, and patients suffering from osteoporosis, structural allografts can be used to enhance the stability of the construct. An individually shaped allograft has been suggested in the literature and investigated in a clinical setting. However, biomechanical properties have yet to be evaluated. MATERIALS AND
methodsTwenty-four fresh-frozen humeri and 12 femoral heads were obtained, and an unstable three-part fracture of the humeral head was simulated. Fracture fixation was achieved by using a locking plate in both groups. In the test group, a mushroom-shaped allograft was tailored out of a femoral head to individually fit the void inside the humeral head. Specimens were fitted with a 3D motion analysis system and cyclically loaded with a stepwise increasing load magnitude in a varus-valgus bending test until failure or up to a maximum of 10,000 load cycles.
resultsThe mushroom group reached a significantly higher number of load cycles (8342; SD 1,902; CI 7133-9550) compared to the control group (3475; SD 1488; CI 2530-4420; p < 0.001). Additionally, the test group showed significantly higher stiffness values concerning all observational points (p < 0.001).
conclusionThis mushroom-shaped allograft in combination with a locking plate significantly increased load to failure as well as stiffness of the construct when exposed to varus-valgus bending forces. Therefore, it might be a viable option for surgical treatment of unstable and varus displaced proximal humerus fractures to superiorly prevent loss of reduction and varus collapse.
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