Fixed-angle plate fixation in simulated fractures of the proximal humerus: a biomechanical study of a new device

This study was performed to evaluate the biomechanical properties of a new device for displaced fractures of the proximal humerus. The device is a low-profile, fixed-angle plate specially designed for percutaneous application. With the use of embalmed cadaveric humeri, we simulated both noncomminuted and comminuted 2-part surgical neck fractures of the proximal humerus. Each humerus of a pair was then randomly fixed with either the new experimental device or the Association for the Study of Internal Fixation (ASIF) T-plate and mechanically tested to failure in an axial shear-loading model. The two fixation devices were evaluated in paired humeri with regard to mode of failure, stiffness, displacement at physiologic loads, and displacement, load, and energy at the point of ultimate load before failure. In the noncomminuted fracture trials the experimental device exhibited significantly greater stiffness (P < .001; P = .002 for normalized values) and ultimate load before failure (P = .015) and significantly less displacement at higher physiologic loads (P = .031). In the comminuted fracture trials the experimental device exhibited significantly greater stiffness (P = .048), ultimate load (P < .001) and energy absorbed (P = .048) before failure, and significantly less displacement at higher (P = .004) and lower physiologic loads (P = .011). The study demonstrates improved biomechanical properties for the new experimental device over the T-plate in simulated fractures of the proximal humerus. We extrapolate that these improved biomechanical properties may prove advantageous in future clinical investigation.