Does Supplemental Intramedullary Grafting Increase Stability of Plated Proximal Humerus Fractures?

Objectives: To investigate the biomechanical competence of locked plating augmented with supplemental intramedullary graft in comparison to conventional locked plate fixation in proximal humerus fractures (PHF). Methods: Complex four-part PHFs were set in 30 artificial humeri assigned to 3 study groups (n = 10 in each group). Group 1 was characterized by loss of medial support, group 2 by simulated severe cancellous bone damage due to osteoporosis, and group 3 by combination of the 2 features. After locked plating, each specimen underwent nondestructive quasi-static mechanical testing in 25 degrees lateral angulation under axial loading between 150 and 400 N in 50-N increments, accompanied by consecutive anteroposterior x-ray imaging. Subsequently, an additional 3D-printed intramedullary graft was inserted into each specimen and all tests were repeated. Results: Grafting resulted in significantly higher axial stiffness compared with no graft in groups 1 and 3 (P
Source: Journal of Orthopaedic Trauma - Category: Orthopaedics Tags: Original Article Source Type: research