ArticleEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2026
Hydroxyapatite/poly-L-lactide mesh tube versus β-tricalcium phosphate granules in locking plate fixation of proximal humeral fractures: a retrospective comparative study.
Article in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeProximal humeral fractures in older adults are often accompanied by metaphyseal bone defects, leading to reduction loss after plate fixation. Fibular allograft struts provide effective augmentation. However, their availability is limited. This study aimed to compare the outcomes of using hydroxyapatite/poly-L-lactide (HA/PLLA) mesh tubes as endosteal struts and β-tricalcium phosphate (β-TCP) granules for augmentation in locking plate osteosynthesis for proximal humeral fractures.
methodsThis retrospective study included 42 adult patients who underwent locking plate fixation for acute, closed proximal humeral fractures at a single institution between 2013 and 2022. Among them, 20 patients received endosteal strut-HA/PLLA mesh tube (group E), and 22 received β-TCP granules (group G). Demographics, radiographic outcomes (humeral head height and neck-shaft angle), range of motion, complications, and surgical parameters were compared between the two groups.
resultsGroup E showed a significantly smaller mean change in humeral head height than group G (1.5 ± 3.1 vs. 4.0 ± 4.0 mm, p = 0.01). No significant difference in the mean change in neck-shaft angle was observed between the two groups (p = 0.31). Furthermore, no significant differences were observed in shoulder range of motion, complication rates, operative time, or blood loss between the two groups.
conclusionThe use of HA/PLLA mesh tube as an intramedullary strut in locking plate osteosynthesis provided superior maintenance of humeral head height compared with β-TCP granules, without increasing complications. Endosteal strut-HA/PLLA mesh tubes may be a practical and safe alternative to allograft struts for augmentation in settings where allografts are unavailable.
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