Indirect medial reduction and strut support of proximal humerus fractures using an endosteal implant

Abstract

Fractures of the proximal humerus, particularly in osteoporotic bone, are still frequently referred to as unsolved fractures. The recent explosion of locking plate technology has included these fractures, but it appears that laterally placed locking plates may not be as predictable as hoped. Medial column mechanical support of these fractures may play a significant role in the ultimate stability of fixation during rehabilitation until healing occurs. We have devised a technique of using a segment of fibula allograft, placed endosteally and incorporated into the locking construct, to aid in the reduction and restoration of the mechanical integrity of the medial column of the proximal humerus.