Abstract
Locking plate technology has increased fixation (ORIF) of proximal humerus fractures dramatically. However, reported rates of success and complications have varied widely. A number of technical pearls have been recommended to lower the complication rate of this technique. These include valgus reduction of the fracture, metaphyseal shortening for enhanced fracture stability, augmentation of the fixation with sutures though the rotator cuff and plate, and the selective addition of fibular strut allograft augmentation. In addition, delayed postoperative rehabilitation have been associated with success in some case series. Finally, shorter proximal locking screws, to avoid iatrogenic or delayed screw penetration into the joint, have become more frequent. There have been few large, single center studies on the modern application of this technology.
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