Medial Plate Augmentation for 11B and 11C Proximal Humeral Fractures: Surgical Technique Description

Thursday, October 19, 2023

8:00 AM – 5:00 PM PST

Location: Skybridge Lobby

Presenting Author(s)

JR

Juan Reatiga Aguilar, MD

Fundación Campbell, Atlantico, Colombia

Disclosure(s): No financial relationships to disclose

Corresponding Author(s)

Claudia Medina Monje, MD

Scientific Director
Fundación Campbell
Barranquilla, Atlantico, Colombia

Disclosure(s): No financial relationships to disclose

Co-Author(s)

XR

Ximena Rios, MD

Orthopedic and Orthoplastic surgeon
Fundación Campbell
Barranquilla, Atlantico, Colombia
CA

Carlos Almanza, MD

Fundación Campbell, Atlantico, Colombia
LA

Laura Arzuza, Mgs Epidemiology

Fundación Campbell
JM

Juan Molina Gándara, Research Physician

Fundación Campbell, Atlantico, Colombia
JR

Jose Ramos Ripoll, MD
Claudia Medina Monje, MD

Scientific Director
Fundación Campbell
Barranquilla, Atlantico, Colombia

Purpose: Medial column stability is the key to successful surgical treatment of 11B and 11C (OTA/AO Fracture Classification) proximal humeral fractures. The double-plate augmentation fixation technique is a novel treatment that provides double column support and stability of the fracture reduction.

Methods: Seven patients aged <60 years with 11B and 11C proximal humeral fractures with involvement of the medial cortex were studied. A deltopectoral approach is performed through which the fracture is exposed, reduction and varus correction is performed, then provisional fixation with threaded guides and depending on the configuration of the fracture, the order of the plates (lateral and medial) is decided. Follow-up at 12 months postoperatively involved a review of AP and lateral shoulder radiographs and functional assessment using the Disabilities of the Arm, Shoulder and Hand scale.

Results: Most patients were men (87.5%), and the mean age was 36.2 ± 14 years. Fracture consolidation with no medial cortical collapse was achieved in all cases at the 12-month follow-up. There was no varus collapse of the most proximal screws. 85.7% of those affected did not show limitations to perform usual activities after surgical management of the fracture, and 71.4% had a range of motion within functional parameters for daily and work activities.

Conclusion: 11B and 11C proximal humeral fractures can be reconstructed through the double-plate system with good functional and radiological outcomes. This technique is an option to consider as strategy to avoid the varus collapse of the described proximal humeral fractures.

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