{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T06:09:34Z","timestamp":1790834974382,"version":"4.1.0"},"reference-count":24,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,12,8]],"date-time":"2022-12-08T00:00:00Z","timestamp":1670457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Orthopaedic Surgery"],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Calcar comminution has been considered to be the main cause of the failure of internal fixation and fracture nonunion in proximal humerus surgery. Anatomical reduction and increasing the strength of internal fixation is the key to success. The purpose of this study was to investigate the short\u2010term clinical effect of dual plate fixation in the treatment of proximal humeral fractures with calcar comminution.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The data of 37 patients with proximal humeral fractures with calcar comminution, treated in our departments from July 2018 to April 2020, were retrospectively analyzed. These patients were treated with anterior plate and lateral PHILOS plate, and followed up for more than 12\u2009months, including 25 cases in Tianjin Hospital and 12 cases in Shanghai General Hospital. The patients included 12 males and 25 females, their age was 54.89\u2009\u00b1\u200913.59\u2009years (range from 32\u201379\u2009years), and 21 patients had dominant hand injury. According to the Neer classification, there were 11 two\u2010part fractures, 22 three\u2010part fractures, and four four\u2010part fractures. The range of motion of the shoulder joint, visual analog scale (VAS), American Shoulder and Elbow Surgeons Shoulder Score (ASES), Constant\u2013Murley shoulder score, neck\u2010shaft angle, anterior\u2013posterior angle, and other complication scores were recorded at the last follow\u2010up.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>All 37 patients were followed up after operation, and the follow\u2010up time was 21.81\u2009\u00b1\u20097.35\u2009months (range from 12\u201336\u2009months). The fractures of all 37 patients had healed at the last follow\u2010up visit. The neck\u2010shaft angle measured immediately after operation was 132.59\u00b0\u2009\u00b1\u20098.34\u00b0, and the neck\u2010shaft angle measured at the last follow\u2010up visit was 132.38\u2009\u00b1\u20098.53\u00b0. The anterior\u2013posterior angle measured immediately after surgery was 3.45\u00b0\u2009\u00b1\u20090.81\u00b0, and the anterior\u2013posterior angle at the last follow\u2010up visit was 3.66\u00b0\u2009\u00b1\u20090.77\u00b0. The range of motion of the shoulder joint was as follows: the shoulder joint could be forward elevated by 158.11\u00b0\u2009\u00b1\u200913.09\u00b0 (range: 140\u00b0\u2013180\u00b0), rotated externally by 38.38\u00b0\u2009\u00b1\u20097.55\u00b0 (range: 20\u00b0\u201345\u00b0), and internally rotated to T4\u2010L4 level. The VAS score was 0.46\u2009\u00b1\u20090.87 (range: 0\u20133), the ASES was 86.58\u2009\u00b1\u20098.79 (range: 56.7\u2013100), and the Constant\u2013Murley score was 88.76\u2009\u00b1\u20098.25 (range: 60\u2013100). Thirty\u2010three cases were excellent, and four cases were good. No obvious complications occurred.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of anterior plate and lateral PHILOS plate in the treatment of proximal humeral fractures with calcar comminution can achieve stable fixation, and the postoperative clinical and imaging outcome was satisfactory. Firstly, the anterior plate can provide temporary stability when the Kirschner wires are removed, which can provide space for lateral plate placement during fracture reduction and fixation. Secondly, additional support by the anterior plate can provide higher stability in complex fractures with calcar comminution.<\/jats:p><\/jats:sec>","DOI":"10.1111\/os.13601","type":"journal-article","created":{"date-parts":[[2022,12,9]],"date-time":"2022-12-09T05:10:37Z","timestamp":1670562637000},"page":"1990-1996","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Short\u2010term Clinical Outcome of Dual Plate Fixation in the Treatment of Proximal Humerus Fractures with Calcar Comminution"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0613-4459","authenticated-orcid":false,"given":"Junyang","family":"Liu","sequence":"first","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peng","family":"Cui","sequence":"additional","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7280-6455","authenticated-orcid":false,"given":"Xiaoming","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Traumatology, Trauma Center, Shanghai General Hospital Shanghai Jiao Tong University School of Medicine  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Han","sequence":"additional","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangyu","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingming","family":"Dong","sequence":"additional","affiliation":[{"name":"Department of No. 2 Upper Extremity Traumatology Tianjin Hospital  Tianjin China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,12,8]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ocl.2018.10.005"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2017.05.029"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.93B1.25702"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12777"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-017-0639-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e3181920e5b"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2010.08.030"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2011.09.024"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/os.12788"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2008.06.014"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2012.04.015"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018-017-0573-4"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0b013e31815b3922"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11999-011-1949-0"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00264-015-2950-0"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.16.00112"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.58B3.956247"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12306-012-0195-2"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2008.06.014"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000002404"},{"issue":"7","key":"e_1_2_8_22_1","first-page":"560","article-title":"Double plating for obsolete proximal humeral fractures with instability of medial metaphysis","volume":"16","author":"Lu Y","year":"2014","journal-title":"Chin J Orthop Trauma"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-013-1255-5"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1097\/BOT.0000000000001515"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.01144"}],"container-title":["Orthopaedic Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13601","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/os.13601","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/os.13601","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,20]],"date-time":"2023-08-20T21:24:37Z","timestamp":1692566677000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/os.13601"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,8]]},"references-count":24,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,8]]}},"alternative-id":["10.1111\/os.13601"],"URL":"https:\/\/doi.org\/10.1111\/os.13601","archive":["Portico"],"relation":{},"ISSN":["1757-7853","1757-7861"],"issn-type":[{"value":"1757-7853","type":"print"},{"value":"1757-7861","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,8]]},"assertion":[{"value":"2022-07-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-10-26","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-12-08","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}