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Tension wiring to increase stability of conventional plating for proximal humeral fractures: An alternative to a locking plate

Kai-Lan Hsua,b,c, Ta-Wei Taib,c, Wei-Ren Sub, Chii-Jeng Linb, Pei-Yuan Leec,d*

aDivision of Orthopaedics, Department of Surgery, National Cheng Kung University Hospital, Dou-Liou Branch, Yunlin, Taiwan, bDepartment of Orthopedics, National Cheng Kung University Hospital, Tainan, Taiwan, cDepartment of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan, dDepartment of Orthopaedics, Show Chwan Memorial Hospital, Changhua, Taiwan

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

Abstract Fixation of comminuted or osteoporotic fractures in the proximal humerus is a challenge for orthopedic surgeons. In the past two decades, locking plates have been used for proximal humeral fracture fixation. However, complications such as loss of reduction have been reported, and the implants are not always available in some regions. Therefore, we describe an alternative procedure involving fixation with a nonlocking cloverleaf plate augmented with tension wiring to provide adequate stability and prevent loss of reduction.

Keywords: Cloverleaf plate, Proximal humerus, Tension wire

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