正骨手法结合经皮锁定钢板固定治疗老年肱骨近端骨折的病例对照研究

目的 :探讨正骨手法闭合复位结合经皮微创固定治疗老年肱骨近端骨折的临床研究。方法 :2012年2月至2013年12月,收治老年肱骨近端骨折共39例,男17例,女22例;年龄67~88岁,平均(71.8±5.2)岁。分为经皮微创锁定钢板固定治疗组(MIPPO组)和切开复位锁定钢板内固定治疗组(ORIF组)。MIPPO组21例,男11例,女10例;平均年龄(70.0±5.3)岁;术中先用正骨手法闭合复位肱骨近端,位置满意后经皮锁定钢板固定治疗。ORIF组18例,男10例,女8例;平均年龄(72.0±4.2)岁;采取经三角肌胸大肌间隙入路,切开复位骨折后锁定钢板内固定治疗。记录两组患者的手术时间、术中出血量、骨折愈合时间及术后并发症。末次随访时应用Constant-Murley评分系统对患肩进行评定。结果:39例均获随访,时间11~27个月,平均18.1个月。MIPPO组平均出血量(176.0±57.4)ml,少于ORIF组的(356.0±66.9)ml;MIPPO组手术时间平均(47.4±14.9)min,短于ORIF组的(92.7±15.8)min;MIPPO组骨折愈合时间平均(17.6±5.8)周,短于ORIF组的(21.7±4.9)周。肩关节功能Constant-Murley评分,MIPPO组89.7±14.5,优于ORIF组的81.8±13.2。结论:正骨手法整复微创锁定钢板固定治疗肱骨近端骨折,具有创伤小、血供破坏少、固定可靠等优点,是治疗老年性肱骨近端骨折的有效方法。     

微创钢板内固定结合肱骨近端锁定钢板在肱骨骨折治疗中的应用

目的探讨运用经皮微创钢板内固定技术（MIPPO）结合肱骨近端锁定钢板（LPHP）治疗肱骨近端骨折的临床疗效。方法回顾性分析本组2010年2月至2014年3月采用MIPPO技术结合LPHP治疗肱骨近端骨折患者28例,传统切开复位内固定（ORIF）患者25例。比较两组术中切口长度、出血情况、手术时间、术后骨折愈合时间、肩关节功能恢复,并进行统计学分析。结果 53例均获得随访,随访时间6-20个月,平均14.3个月,MIPPO组在手术切口、手术时间、出血量优于ORIF组,差异具有统计学意义（P〈0.05）;而在骨折愈合时间及肩关节功能恢复方面两组无统计学差异（P〉0.05）。结论应用MIPPO技术结合LPHP内固定较ORIF结合LPHP治疗肱骨近端骨折具有创伤小,固定可靠的优势,是治疗肱骨近端骨折更为合适的手段。     

微创钢板接骨术和传统切开复位内固定术治疗肱骨近端骨折的比较研究

目的比较微创经皮钢板接骨术(MIPPO)和传统切开复位内固定(ORIF)手术治疗肱骨近端骨折的临床效果。方法回顾性分析2010年1月至2013年1月廉江市人民医院和湛江中心人民医院收治的68例肱骨近端骨折患者的临床资料,其中32例采用MIPPO技术(MIPPO组),36例行ORIF治疗(ORIF组),两组钢板均选用肱骨近端锁定接骨板。比较两组手术时间、术中出血量,观察术后并发症发生率情况,采用肩关节Neer评分标准进行术后功能评价。结果 68例患者均获得随访,随访时间12~14个月,平均随访时间12.5个月。MIPPO组手术时间及术中出血量均少于ORIF组,两组比较,差异有统计学意义(P0.05)。ORIF组1例术后感染行二次手术治疗,2例术后半年出现肱骨头坏死;两组均未出现皮肤坏死、神经功能损伤及内固定松动、断裂并发症。术后1年随访时MIPPO组和ORIF组Neer评分优良率分别为94%(30/32)和75%(27/36),两组比较,差异有统计学意义(P0.05)。结论对于肱骨近端骨折而言,MIPPO较之ORIF操作简便,手术创伤小,术后并发症少,肩关节功能恢复良好。     

经皮锁定钢板内固定治疗肱骨近端骨折的临床效果

目的 探讨经皮锁定钢板内固定在治疗肱骨近端骨折的应用和临床效果.方法 应用经皮锁定钢板内固定治疗32例肱骨近端骨折,其中二部分骨折12例,三部分骨折14例,四部分骨折6例,记录手术时间、出血量、切口长度、术后并发症、骨折愈合时间,采用肩关节Constant评分标准评价疗效.结果 手术时间平均45min;出血量平均85ml;近端切口长度平均4cm;远端切口长度平均2cm;平均随访时间14.5个月,骨折愈合时间平均7周,无腋神经损伤,无复位丢失,随访结束时未发现肱骨头坏死病例.根据肩关节Constant评分标准,优良率84.4%.结论 经皮锁定钢板内固定治疗肱骨近端骨折对血运破坏小,固定牢靠,允许术后早期功能锻炼,在正确掌握手术操作技巧的前提下,是治疗肱骨近端骨折的较好方法 .     

三种内固定治疗粉碎性肱骨大结节骨折的疗效比较

目的比较解剖型锁定钢板、肱骨近端内固定锁定系统(PHILOS)及解剖型锁定钢板联合锚钉治疗粉碎性肱骨大结节骨折的疗效。方法回顾性分析同济大学附属同济医院骨科自2016年10月至2021年10月收治的33例粉碎性肱骨大结节骨折的患者资料。男20例, 女13例;年龄(53.5±13.6)岁。根据手术方式不同分为3组:A组12例(经三角肌入路解剖型锁定钢板内固定治疗), B组10例(经胸大肌三角肌入路PHILOS钢板内固定治疗), C组11例(采用三角肌入路解剖型锁定钢板联合锚钉内固定治疗)。记录并比较3组患者手术时间、术中出血量、肩关节活动度、Constant-Murley肩关节功能评分(Constant评分)、疼痛视觉模拟评分(VAS)及术后并发症发生情况。结果三组患者术前一般资料比较差异均无统计学意义(P>0.05), 具有可比性。所有患者术后获(14.5±4.1)个月随访, 末次随访时骨折均愈合。A、B、C三组患者手术时间分别为(57.9±7.8)、(73.0±7.1)、(63.6±9.5)min, 术中出血量分别为(41.7±18.9)、(82.0±22.9)、(46.4±1...     

微创经皮钢板接骨术在肱骨近端骨折治疗中的应用

目的 探讨微创经皮钢板接骨术(MIPPO)联合肱骨近端锁定内固定系统治疗肱骨近端骨折的临床效果. 方法 回顾性分析2008年11月至2011年1月收治的29例肱骨近端骨折患者资料,男18例,女11例;年龄30 ～ 81岁,平均57岁.应用MIPPO结合肱骨近端内固定系统治疗,术后进行随访,评价手术优点和治疗结果.结果 29例患者术后获4～18个月(平均9个月)随访,根据Neer评分系统评定疗效:优15例,良11例,可2例,差1例,优良率为89.7％.所有患者骨折均获愈合,切口长度平均为4.0cm.骨折线模糊的时间或消失的时间为4～8周,平均5.3周,1例患者由于术后康复不配合,导致肩关节活动部分受限. 结论 新型MIPPO联合肱骨近端内固定锁定系统微创治疗肱骨近端骨折可获得满意疗效.     

锁定加压钢板与解剖型钢板内固定治疗肱骨近端骨折疗效比较研究

目的：对比分析锁定加压钢板与解剖型钢板内固定治疗肱骨近端骨折的临床效果,探讨合适的肱骨近端骨折内固定方法。方法对2007年1月至2013年1月苏州市第七人民医院收治的63例肱骨近端骨折患者的临床资料进行回顾性分析,其中31例采用锁定加压钢板固定,32例行解剖型钢板固定。观察术后并发症发生情况,根据Neer评分标准对疗效进行评定。结果锁定加压钢板组25例患者获得有效随访,随访时间6～36个月,平均随访时间16个月;解剖型钢板组29例患者获得有效随访,随访时间7～48个月,平均随访时间26个月。锁定加压钢板组术后肩关节功能Neer评分优良率优于解剖型钢板组,但两组比较,差异无统计学意义（96% vs 90%,P＞0.05）。解剖型钢板组1例患者发生肱骨头坏死、吸收,2例出现螺钉松动、部分拔出。两组均未出现断钉、再骨折移位、骨折不愈合、桡神经损伤、腋神经损伤等术后并发症。结论锁定加压钢板和解剖型钢板内固定均能有效治疗肱骨近端骨折,但锁定加压钢板内固定并发症少,更加安全可靠。     

锁定钢板联合内侧支撑螺钉内固定治疗肱骨近端骨折的疗效分析

目的探讨锁定钢板联合内侧支撑螺钉内固定治疗肱骨近端骨折的临床疗效。方法回顾性分析自2016-01—2019-03采用锁定钢板内固定治疗的63例肱骨近端骨折,30例在术中置入内侧支撑螺钉(观察组),33例未在术中置入内侧支撑螺钉(对照组),比较2组末次随访时肱骨头高度丢失情况、内翻角度、Constant肩关节功能评分。结果63例均获得随访,随访时间7~36个月,平均16.5个月。63例均骨性愈合,无切口感染、内固定断裂等并发症,对照组1例出现肱骨头坏死。末次随访时观察组肱骨头高度丢失较对照组少,内翻角度较对照组小,Constant肩关节功能评分较对照组高,差异有统计学意义(P<0.05)。结论锁定钢板联合内侧支撑螺钉内固定治疗肱骨近端骨折,可以减少复位丢失及肱骨头内翻移位,有利于肩关节功能的恢复。     

经三角肌MIPPO技术肱骨近端锁定接骨板内固定治疗肱骨近端骨折

目的探讨经三角肌微创经皮钢板固定技术(MIPPO)肱骨近端锁定接骨板内固定治疗肱骨近端骨折的手术技巧及临床疗效。方法回顾性分析自2010-03—2015-11采用经三角肌MIPPO技术肱骨近端锁定接骨板内固定治疗的25例肱骨近端骨折。末次随访时采用Constant-Murley评分标准评定肩关节功能。结果本组手术时间70~165 min,平均112.0 min;术中失血量40~110 ml,平均69.5 ml。25例获得平均16.8(12~29)个月随访。骨折均愈合,愈合时间10~18周,平均14.3周。末次随访时采用Constant-Murley评分标准评定肩关节功能:优12例,良10例,可3例,优良率88.0%。结论采用经三角肌MIPPO技术肱骨近端锁定接骨板内固定治疗肱骨近端骨折具有创伤小、出血少、骨折愈合率高、术后功能恢复好等优点,在选择正确手术适应证的前提下可取得良好疗效。     

MIPPO与ORIF治疗Neer Ⅱ型老年肱骨近端骨折病例对照研究

目的 :比较经皮微创接骨板内固定术(MIPPO)与切开复位内固定术(ORIF)两种术式治疗NeerⅡ型老年性肱骨近端骨折的临床疗效。方法:回顾性分析2014年3月至2016年3月分别采用MIPPO与ORIF手术治疗的NeerⅡ型老年性肱骨近端骨折46例患者,其中MIPPO组20例,男9例,女11例,年龄65~80(70.4±4.4)岁;ORIF组26例,男11例,女15例,年龄65~79(70.9±4.0)岁。比较两组术中透视次数,住院时间,骨折愈合时间,术后康复锻炼启动时间,术后3、6、12个月肩关节功能Constant-Murley评分,末次随访关节功能分级及腋神经损伤等并发症情况。结果:46例患者均获随访,时间12~24(16.8±3.7)个月。Mippo组骨折愈合时间(13.0±0.8)周较ORIF组(13.8±1.4)周短,康复锻炼启动时间(3.0±0.9)d较ORIF组(6.8±1.3)d短,术中透视次数(19.2±3.7)次较ORIF组(12.1±3.4)次多。术后3、6个月Constant-Murley肩关节功能评分81.3±3.9和86.6±5.4均高于ORIF组69.5±6.6和80.5±6.7。但两组住院时间、术后12个月Constant Murley肩关节功能评分及末次关节功能分级差异均无统计学意义;MIPPO组有1例腋神经损伤,ORIF组有2例延迟愈合,两组各有1例复位丢失,均无感染、内固定断裂等。结论:MIPPO与ORIF均能治疗NeerⅡ型老年性肱骨近端骨折,前者具有术后恢复更快、康复锻炼更早、早期肩关节功能恢复好等优点,但存在腋神经损伤、X线暴露多等缺点。     

手法闭合复位经皮微创固定治疗肱骨近端骨折的病例对照研究

目的：采用手法闭合复位经皮运用锁定接骨板微创固定治疗肱骨近端骨折与常规切口切开复位内固定治疗肱骨近端骨折,比较两种方法临床效果.方法：2008年4月至2012年3月,75例肱骨近端骨折,男26例,女49例;年龄22～80岁,平均52.1岁;受伤至手术时间平均2.2d;分为微创组和常规组.微创组33例,男12例,女21例;平均年龄（47.30±8.72）岁;Neer分型Ⅱ型22例,Ⅲ型11例;在手法闭合复位后,采用锁定接骨板经肩峰下三角肌小切口插入固定进行治疗.常规组42例,男16例,女26例;平均年龄（49.10±9.29）岁;Neer分型Ⅱ型27例,Ⅲ型15例;手术经常规的三角肌胸大肌间隙入路,显露骨折端,直视下复位后用锁定接骨板固定治疗.分别记录两种术式的手术操作时间、出血量和手术切口长度;应用VAS评分记录术后1、3d手术伤口疼痛情况;比较两组骨折愈合时间,随访记录采用Constant-Murley评分对疗效进行评定并进行两组比较,同时比较两种患者术后肩关节正位X线片上肱骨近端颈干角.结果：75例均获随访,时间8～24个月.微创组手术切口（6.74±0.38） cm,常规组（16.82±1.74） cm,微创组较常规组切口小;微创组出血（110.15±29.49） ml,常规组（326.19±59.71）ml,微创组较常规组出血少;微创组手术时间（48.60±10.18） min,常规组（68.84±16.22） min,微创组较常规组手术时间短.常规组3例出现骨不连并再次手术,2例出现肱骨头坏死.微创组Constant-Murley评分88.94±2.57,常规组86.00±3.36,微创组评分高于常规组.结论：手法复位经皮运用锁定接骨板微创固定治疗肱骨近端骨折,既能减少手术创伤,又能保证关节的早期功能活动,使肩关节功能迅速恢复,具有创伤小、血运破坏少、固定可靠等优点,与常规手术方法相比更具有优势.     

经皮微创钢板内固定与切开复位内固定治疗成人胫骨远端骨折的Meta分析

目的:对经皮微创钢板内固定术(MIPPO)与切开复位内固定术(ORIF)治疗成人胫骨远端骨折的疗效进行Meta分析。方法:通过计算机检索Pubmed(1968年至2014年3月),Cochrane图书馆、中国知网数据库(1998年至2014年3月),手工检索相关的中英文骨科杂志。收集MIPPO与ORIF治疗成人胫骨远端骨折的病例对照研究,选择术后感染率、手术时间、术中出血量、骨折不愈合率、骨折延迟愈合、骨折畸形愈合率作为Meta分析的评价指标,按Cochrane协作网推荐的方法进行系统评价。结果:共纳入5项研究366例患者。Meta分析结果显示:MIPPO组感染率低于ORIF组[OR=0.23,95%CI(0.06,0.92),P=0.04];MIPPO组骨折不愈合率低于ORIF组[OR=0.16,95%CI(0.03,0.76),P=0.02];ORIF组骨折畸形愈合率低于MIPPO组[OR=7.46,95%CI(1.68,33.10),P=0.008];MIPPO组手术时间短于ORIF组[MD=-14.42,95%CI(-27.79,-1.05),P <0.05];MIPPO组术中出血量少于ORIF组[MD=-87.17,95%CI(-99.20,-75.15),P <0.05];两组骨折延迟愈合率比较差异无统计学意义。结论:对于成人胫骨远端骨折,与切开复位内固定治疗相比,经皮微创钢板内固定治疗手术时间短、出血量较少、术后感染率和骨折不愈合率低,但骨折畸形愈合率高。总体来看MIPPO较ORIF治疗成人胫骨远端骨折更有优势,但最佳治疗方案的选择应结合患者的病情进行综合考虑。     

经皮微创锁定钢板内固定术与传统切开复位内固定术治疗肱骨近段粉碎性骨折疗效比较

目的比较经皮微创锁定钢板内固定术(MIPPO)和传统AO切开复位普通钢板内固定术(ORIF)治疗肱骨近段粉碎性骨折的临床效果。方法对肱骨近段粉碎性骨折用MIPPO技术治疗24例、传统ORIF治疗20例,对两组的临床效果进行比较。结果MIPPO组有2例术中进行骨移植术;术后随访20～48(25.3±3.4)个月,均获骨性愈合,骨折愈合时间12～20(14.83±3.83)周;3例有5°以上的轻度内外翻畸形;按Neer功能评分:优13例,良8例。ORIF组有9例进行骨移植术;随访20～48(21.2±3.1)个月,3例出现肱骨头坏死,余患者均获得骨性愈合,骨折愈合时间16～32(24.24±4.88)周;2例发生5°的外翻畸形,1例出现螺钉松动;Neer功能评分:优5例,良7例。两组均无感染和内固定断裂等并发症发生。两组在骨折愈合时间和功能恢复方面比较,差异有统计学意义(P<0.05)。结论用MIPPO技术治疗肱骨近段粉碎性骨折可以降低植骨需求,在骨折愈合及术后功能恢复方面有明显优势。     

Open Reduction and Internal Fixation Better than Percutaneous Plate Osteosynthesis in Distal Tibial Fractures

ABSTRACT

Minimally invasive percutaneous plate osteosynthesis (MIPPO) was compared with traditional open reduction and internal fixation (ORIF) in treating distal tibial fractures. Patients diagnosed with displaced extraarticular distal tibial fractures during October 2005–June 2007 were randomly assigned to a closed (treated using MIPPO) and an open (treated using ORIF) group. Ninety-four patients with fractures were treated and followed up, of which 42 and 52 patients were enrolled in the open and closed groups, respectively. The 94 fracture cases were classified into three types: Type A, 52 (55.3%); Type B, 24 (25.5%); and Type C, 18 (19.1%). The average follow-up time was 15.6 and 16.2 months for the open and closed groups, respectively. In the open group, 35 fractures healed within six months. Delayed union was observed in three fractures and nonunion in four fractures. Two cases had superficial wound infection after operation. No malunion was observed. In the closed group, 47 fractures healed within six months. Delayed union was observed in four fractures. Locking plate was broken nine months after operation in one case. Malunion was observed in five cases: two rotational and three posterior angular deformities. No statistically significant differences were observed in the healing time of Types A and B between the open and closed groups (p > .05). The healing time of Type C in the open group was longer than that in the closed group (p < .05). The first choice for Type C fractures is MIPPO, whereas that for Type A is open reduction.     

Intramedullary nailing of displaced four-part fractures of the proximal humerus

BackgroundIntramedullary nailing is already established technique for the treatment of two and three-part fractures of proximal humerus. The aim of the study was to prospectively evaluate the efficacy and functional outcome after treatment of four-part fractures of proximal humerus with Multiloc proximal humeral nail.Designprospective monocentric cohort study.Settingsingle level 1 traumacenter.Materials and MethodsFrom February 2011 to March 2016, 40 patients with displaced four-part proximal humeral fractures were treated with intramedullary nail inserted through anterolateral approach. Minimum one year follow up completed 35 patients and were involved into the study.ResultsAfter mean follow up period of 25.8 months 29 of 35 fractures healed. Average absolute Constant score in all 35 patients reached 57.7 points, relative side related Constants score 66.8% of contralateral extremity. Together there were 20 complications. in 6 cases (17%) developed complete avascular necrosis of the head. One deep infection was treated by implantation of antibiotic cement discs. Twelve secondary surgeries were performed, mostly for avascular necrosis development. Function and pain were significantly influenced by the quality of fracture reduction (p < 0.05) and development of complete AVN (p = 0.001). Group of 29 patients without AVN reached relative Constant score 73% of contralateral extremity.ConclusionsIntramedullary nailing can be used as possible fixation technique for the treatment of four-part fractures of proximal humerus. In experienced hands provides nailing osteosynthesis similar results as reconstruction with locking plates. Appropriate reduction of fracture fragments is the key for good functional result.Level of evidenceLevel 2b – monocentric prospective cohort study.     

Factors Influencing the Varus Deformity of Humeral Head in Proximal Humerus Fractures and Its Relation to Functional Outcome

BackgroundFractures of the proximal humerus represent approximately 4% of all fractures and 26% of humerus fractures. Proper reduction, stable internal fixation and early initiation of physiotherapy help to achieve a good functional outcome. Aim of this study was to evaluate varus fixation/malunion of proximal humerus fractures and its relation to functional outcome.Materials and MethodsWe retrospectively evaluated 32 patients with proximal humerus fractures who were surgically treated between 2015 and 2017 at tertiary care hospital. We divided the patients into three groups on the basis of the neck-shaft angle as valgus group, normal group and varus group to observe the influence of neck-shaft angle on efficacy. Patients were evaluated for functional outcome using the Constant–Murley score.ResultsTwo-part fractures had better functional outcome (Constant score = 75.15) compared to three parts with the moderate functional outcome (Constant score = 68.81) and the four-part fracture had poor functional outcome (Constant score = 52.66). After 6 months of follow-up, 13 patients had a neck-shaft angle of less than 126°. The functional outcome is significantly better among patients with normal neck-shaft angle and had a mean Constant score of 76.63 as compared to patients with varus deformity had a mean Constant score 60 (p = 0.001). 10 patients did not have medial support, in which 08 patients had neck-shaft angle less than 126° and 2 had a normal neck-shaft angle.ConclusionHigh fracture comminution, improper restoration of medial continuity causes varus deformity of the humeral head and it leads to poor functional outcome. The small sample size is the limitation of our study.     

Minimal Invasive PHILOS®-Plate Osteosynthesis in Proximal Humeral Fractures

Abstract Introduction:   The anterior delto-pectoral approach is the standard approach for the fixation of proximal humeral fractures with the PHILOS^?-Plate system. However, this approach can impair the vascular supply and can increase avascular necrosis. The objective of this study was to evaluate the results and complexity of surgery of proximal humeral fractures with a minimal invasive (MIPO) approach. Methods:   All PHILOS^?-plate osteosynthesis operated between Januray 2003 and June 2006 were evaluated prospectively. A minimal invasive antero-lateral deltasplit-approach was performed in all two to four fragment instable fractures meeting the indication for osteosynthesis according to Neer. An open approach (ORIF) was chosen in all other fractures mainly dislocated fractures and particularly in fractures with major subcapital displacement. Results:   A cohort of 68 patients suffered a proximal humerus fracture and qualified for a minimal invasive approach with a PHILOS^?-plate osteosynthesis. Of these 68 patients, 41 were locally resident. Eight patients refused a follow-up, two patients were in constant care, and two patients died; 29 patients (71%) (20 females, 9 males) could be documented entirely with a median age of 64 years. The median operation time amounted to 75 min with a fluoroscopic time of 160 s. The median Constant score was 78 after 12 months. All fractures healed in adequate time. One patient showed a lesion of the ventral part of the axillary nerve. No patient suffered an avascular necrosis. Discussion:   The minimal invasive PHILOS^? plate osteosynthesis through an antero-lateral delta-split approach proved to be an elegant procedure for selected fractures of the proximal humerus with a low morbidity and good functional outcome.     

Proximal humeral fractures treated with a low-profile plate with enhanced fixation properties

BackgroundOur purpose was to evaluate the clinical and radiographic outcomes of proximal humeral fractures treated with a new generation plating system and compare results with a meta-analysis of recent literature.MethodsBetween 2014 and 2017, 93 patients (18 males, 75 females) with proximal humerus fractures were treated with open reduction and internal fixation (ORIF) using a Pantera® Plate. These low-profile plates are anatomically shaped and include “cross-elements” that form a three-dimensional scaffold in bone to enhance fixation stability. According to Neer classification, there were 24 two-part fractures, 49 three-part fractures and 20 four-part fractures (4 with dislocated heads). X-rays and Constant Shoulder Scores (CSS) were used to evaluate healing, complications, and clinical outcomes. Results were compared with a meta-analysis of similar studies reported in literature over the last 10 years.ResultsEighty-three patients with a minimum follow-up of 2 years had a mean CSS of 72 (53–90) graded as excellent for 23 patients (28%), good for 35 (42%), fair for 14 (17%), and poor for 11 (13%). Fractures healed without complication in 75 (91%) patients. Eight (9%) complications were observed, i.e., three avascular necrosis of the humeral head, one case of implant loosening, two cases of subacromial impingement and two superficial infections. There was no significant correlation between Neer fracture stage and patient outcome (p = 0.257). Compared to the literature, this method had a lower complication grade (p = 0.03), though it did not significantly differ in its clinical outcomes (p = 0.08).ConclusionsThe investigated plating system includes design features that can potentially increase utility for ORIF of proximal humeral fractures. While the complication profile was signficantly less than reported in the literature for standard proximal humerus plates, clinical outcomes were similar. Further studies will be required to better understand the role of plate design on treatment of these challenging fractures.Level of evidenceIV, therapeutic study.