To the Editor:Proximal humeral fracture(PHF)predominantly occurs in patients older than 60 years old with severe osteoporosis.[1]Although a majority of PHFs can be treated non-operatively,the complicated ones require ...To the Editor:Proximal humeral fracture(PHF)predominantly occurs in patients older than 60 years old with severe osteoporosis.[1]Although a majority of PHFs can be treated non-operatively,the complicated ones require surgical fixation.[2]In older individuals,the loss of trabecular structure and the calcar region in the proximal humeral medullary cavity makes them prone to comminuted fracture and loss of medial hinge support,leading to a high rate of implant failure and reoperation.[3]Recent studies have shown that endosteal augments incorporated into the locking plate construct might provide better medullary support and mechanical stability.[1]However,the endosteal augments used in PHF fixation are of different shapes,modes,and positions,which can lead to implant failure and reduction loss.[1,4,5]This may be because of a lack of understanding of the morphological changes that take place in the proximal humerus at different ages.Therefore,in this study,we analyzed and compared the anatomical degeneration pattern of the medullary canal between older and younger patients to have a better understanding of the medullary morphology of proximal humerus anatomically and the application of endosteal support clinically.展开更多
基金This work was supported by grant from the National Natural Science Foundation of China(No.81772336)。
文摘To the Editor:Proximal humeral fracture(PHF)predominantly occurs in patients older than 60 years old with severe osteoporosis.[1]Although a majority of PHFs can be treated non-operatively,the complicated ones require surgical fixation.[2]In older individuals,the loss of trabecular structure and the calcar region in the proximal humeral medullary cavity makes them prone to comminuted fracture and loss of medial hinge support,leading to a high rate of implant failure and reoperation.[3]Recent studies have shown that endosteal augments incorporated into the locking plate construct might provide better medullary support and mechanical stability.[1]However,the endosteal augments used in PHF fixation are of different shapes,modes,and positions,which can lead to implant failure and reduction loss.[1,4,5]This may be because of a lack of understanding of the morphological changes that take place in the proximal humerus at different ages.Therefore,in this study,we analyzed and compared the anatomical degeneration pattern of the medullary canal between older and younger patients to have a better understanding of the medullary morphology of proximal humerus anatomically and the application of endosteal support clinically.
