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Subsequently, the radiological and clinical outcomes were evaluated over an average follow-up period of 18.53 months.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>The average operation time was 108\u00a0min (range, 70\u2013130\u00a0min), and the mean fracture union time in all patients was 12.13 weeks (range, 8\u201316 weeks). Complications such as infection and neurovascular injury were not observed. Postoperative X-ray showed avascular necrosis and screw penetration in one patient, while screw penetration, varus malunion, or significant reduction loss was not found in the other cases. The mean Constant score was 79.8 (range, 68\u201392) during the final visit.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The use of an anteromedial small locking plate improved the reduction efficiency, reconstructed the medial support, and alleviated the occurrence of complications in proximal humeral fractures with medial instability.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12893-021-01388-9","type":"journal-article","created":{"date-parts":[[2021,10,31]],"date-time":"2021-10-31T20:32:39Z","timestamp":1635712359000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Reduction and fixation of proximal humeral fracture with severe medial instability using a small locking plate"],"prefix":"10.1186","volume":"21","author":[{"given":"Yuelei","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lifu","family":"Wan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lecheng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8740-9727","authenticated-orcid":false,"given":"Gang","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2021,10,31]]},"reference":[{"key":"1388_CR1","doi-asserted-by":"publisher","first-page":"1075","DOI":"10.1007\/s00402-019-03162-2","volume":"139","author":"N Biermann","year":"2019","unstructured":"Biermann N, Prall WC, B\u00f6cker W, Mayr HO, Haasters F. 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