{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T15:46:44Z","timestamp":1789055204200,"version":"build-2803163510"},"reference-count":34,"publisher":"Medical Association of Zenica-Doboj","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicinski Glasnik"],"published-print":{"date-parts":[[2019,5,10]]},"abstract":"<jats:p>&amp;lt;p&amp;gt;&amp;lt;strong&amp;gt;Aim &amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt;Proximal humeral fractures are common and most complex patterns currently represent a challenge for surgeons. Difficulties in obtaining good anatomical reduction (particularly of great tuberosity) often lead to unsatisfactory results; choices often fall onto prosthesis implantation against fixation options. The aim of this study was to compare a new design of proximal humeral plate with the most used plates in the treatment of these injures by analysing outcomes and complications. &amp;lt;strong&amp;gt;Methods&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; Two hundred patients with proximal 3 or 4 parts humeral fracture were enrolled (Neer 3-4). First group treated with PGR Plate composed of 98 patients. Second group treated with Philos Plate composed of 102 patients. Evaluation criteria were Non-Union Scoring System, duration of surgery, complications, objective quality of life and elbow function (Constant Shoulder Score), subjective quality of life and elbow function (Oxford Shoulder Score), post-op radiographs, centrum collum diaphyseal angle. Evaluation endpoint was 12 months. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Results&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; There was no statistically significant difference between the groups with regard to the selected evaluation parameters. Achievement of good shoulder range of motion and ability to perform normal daily living activities was obtained in both groups. The PGR had a positive impact on treatment results of varuspattern of proximal humeral fractures. &amp;lt;br \/&amp;gt;&amp;lt;strong&amp;gt;Conclusions&amp;lt;br \/&amp;gt;&amp;lt;\/strong&amp;gt; The PGR allowed good clinical and radiographic results in the treatment of proximal humeral fractures, comparable to those obtained with Philos. Also, PGR had the advantage to aid and keep the anatomical reduction of patterns of fracture involving the greater tuberosity.&amp;lt;\/p&amp;gt;<\/jats:p>","DOI":"10.17392\/1033-19","type":"journal-article","created":{"date-parts":[[2024,4,21]],"date-time":"2024-04-21T10:20:46Z","timestamp":1713694846000},"page":"284-291","source":"Crossref","is-referenced-by-count":3,"title":["A new plate design to treat displaced 3-4 parts proximal humeral fractures in comparison to the most tested and used plate: clinical and radiographic study"],"prefix":"10.17392","volume":"16","author":[{"given":"Giuseppe","family":"Rollo","sequence":"first","affiliation":[{"name":"Vito Fazzi Hospital","place":["Lecce,Italy"],"department":["Department of Orthopaedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Porcellini","sequence":"additional","affiliation":[{"name":"University of Modena and Reggio Emilia","place":["Modena,Italy"],"department":["Department of Orthopaedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Rotini","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit, \u201cRizzoli\u201d Orthopaedic Institute","place":["Bologna,Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Bisaccia","sequence":"additional","affiliation":[{"name":"University of Perugia, \u201cS. Maria della Misericordia\u201d Hospital","place":["Perugia,Italy"],"department":["Division of Orthopaedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Pichierri","sequence":"additional","affiliation":[{"name":"Vito Fazzi Hospital","place":["Lecce,Italy"],"department":["Department of Orthopaedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Paladini","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit, \u201cD. Cervesi\u201d Hospital, Cattolica-AUSL della Romagna, Ambito Rimini"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Guerra","sequence":"additional","affiliation":[{"name":"Shoulder and Elbow Unit, \u201cRizzoli\u201d Orthopaedic Institute","place":["Bologna,Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enio","family":"De Cruto","sequence":"additional","affiliation":[{"name":"Vito Fazzi Hospital","place":["Lecce,Italy"],"department":["Department of Orthopaedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raffaele","family":"Franzese","sequence":"additional","affiliation":[{"name":"University of Campania \u201cLuigi Vanvitelli\u201d","place":["Naples,Italy"],"department":["Multidisciplinary Department of Medical-Surgical and Dental Specialties"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Predrag","family":"Grubor","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Banja Luka","place":["Banja Luka,Bosnia and Herzegovina"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerio","family":"Pace","sequence":"additional","affiliation":[{"name":"University of Perugia, \u201cS. Maria della Misericordia\u201d Hospital","place":["Perugia,Italy"],"department":["Division of Orthopaedics and Trauma Surgery"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3669-189X","authenticated-orcid":false,"given":"Luigi","family":"Meccariello","sequence":"additional","affiliation":[{"name":"Vito Fazzi Hospital","place":["Lecce,Italy"],"department":["Department of Orthopaedics and Traumatology"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"49509","published-online":{"date-parts":[[2019,5,10]]},"reference":[{"key":"ref1","first-page":"159","article-title":"Epidemiology and patho-anatomical pattern of 2,011 humeral fractures: data from the Swedish Fracture Register","author":"CBergdahlC","year":"2016","unstructured":"Bergdahl C, Ekholm C, Wennergren D, Nilsson F, \nM\u00f6ller M. Epidemiology and patho-anatomical \npattern of 2,011 humeral fractures: data from the \nSwedish Fracture Register. BMC Musculoskelet \nDisord 2016; 17:159.","journal-title":"BMC Musculoskelet Disord"},{"key":"ref2","first-page":"191","article-title":"The effect of osteoporosis management on proximal humeral fracture","author":"ASinghA","year":"2015","unstructured":"Singh A, Adams AL, Burchette R, Dell RM, Funa-\nhashi TT, Navarro RA. The effect of osteoporosis \nmanagement on proximal humeral fracture. J Shoul-\nder Elbow Surg 2015; 24:191-8.","journal-title":"J Shoulder Elbow Surg"},{"key":"ref3","first-page":"1697","article-title":"Trends in epidemiology and patho-anatomical pattern of proximal humeral fractures","author":"CBahrsC","year":"2014","unstructured":"Bahrs C, Stojicevic T, Blumenstock G, Brorson S, \nBadke A, Stockle U, Rolauffs B, Freude T. Tren-\nds in epidemiology and patho-anatomical pattern \nof proximal humeral fractures. Int Orthop 2014; \n38:1697-704.","journal-title":"Int Orthop"},{"key":"ref4","first-page":"408","article-title":"A systematic review of locking plate fixation of proximal humerus fractures","author":"RSproulR","year":"2011","unstructured":"Sproul RC, Iyengar JJ, Devcic Z, Feeley BT. A \nsystematic review of locking plate fixation of proxi-\nmal humerus fractures. Injury 2011; 42:408-13.","journal-title":"Injury"},{"key":"ref5","first-page":"305","article-title":"Meta-analysis comparing locking plate fixation with hemiarthroplasty for complex proximal humeral fractures","author":"JDaiJ","year":"2014","unstructured":"Dai J, Chai Y, Wang C, Wen G. Meta-analysis com-\nparing locking plate fixation with hemiarthroplasty \nfor complex proximal humeral fractures. Eur J Ort-\nhop Surg Traumatol 2014; 24:305-13.","journal-title":"Eur J Orthop Surg Traumatol"},{"key":"ref6","article-title":"Interventions for treating proximal humeral fractures in adults.Cochrane Database Syst Rev","author":"HHandollH","year":"2015","unstructured":"Handoll HH, Brorson S. Interventions for treating \nproximal humeral fractures in adults.Cochrane Da-\ntabase Syst Rev 2015:CD000434."},{"key":"ref7","first-page":"39","article-title":"Classifications in brief: the Neer classification for proximal humerus fractures","author":"BCarofinoB","year":"2013","unstructured":"Carofino BC, Leopold SS. Classifications in brief: \nthe Neer classification for proximal humerus fractu-\nres. Clin Orthop Relat Res 2013; 471:39-43.","journal-title":"Clin Orthop Relat Res"},{"issue":"Suppl 6","key":"ref8","first-page":"93","article-title":"Validation of the Non-Union Scoring System in 300 long bone nonunions","author":"GCaloriG","year":"2014","unstructured":"Calori GM, Colombo M, Mazza EL, Mazzola S, \nMalagoli E, Marelli N, Corradi A. Validation of the \nNon-Union Scoring System in 300 long bone non-\nunions. Injury 2014; 45(Suppl 6):S93-7.","journal-title":"Injury"},{"key":"ref9","first-page":"4608","article-title":"Standardised test protocol (Constant Score) for evaluation of functionality in patients with shoulder disorders","author":"IBanI","year":"2013","unstructured":"Ban I, Troelsen A, Christiansen DH, Svendsen SW, \nKristensen MT. Standardised test protocol (Constant \nScore) for evaluation of functionality in patients with \nshoulder disorders. Dan Med J 2013; 60:A4608.","journal-title":"Dan Med J"},{"key":"ref10","first-page":"119","article-title":"The Oxford shoulder score revisited","author":"JDawsonJ","year":"2009","unstructured":"Dawson J, Rogers K, Fitzpatrick R, Carr A. The \nOxford shoulder score revisited. Arch Orthop Trau-\nma Surg 2009; 129:119-23.","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref11","first-page":"331","article-title":"Geometry of the proximal humerus and implications for prosthetic design","author":"RHertelR","year":"2002","unstructured":"Hertel R, Knothe U, Ballmer FT. Geometry of the \nproximal humerus and implications for prosthetic \ndesign. J Shoulder Elbow Surg 2002; 11:331-8.","journal-title":"J Shoulder Elbow Surg"},{"key":"ref12","first-page":"218","article-title":"Biomechanical analysis of the fixation strength of a novel plate for greater tuberosity fractures","author":"AKaisidisA","year":"2018","unstructured":"Kaisidis A, Pantos PG, Bochlos D, Lindner H. Bi-\nomechanical analysis of the fixation strength of a \nnovel plate for greater tuberosity fractures. Open \nOrthop J 2018; 12:218-28.","journal-title":"Open Orthop J"},{"key":"ref13","first-page":"180","article-title":"Biomechanical investigation of locked plate fixation with suture augmentation in a comminuted threepart proximal humerus fracture model","author":"BPalumboB","year":"2017","unstructured":"Palumbo B, Gutierrez S, Santoni B, Mighell, M. Bi-\nomechanical investigation of locked plate fixation \nwith suture augmentation in a comminuted three-\npart proximal humerus fracture model. Open Journal \nof Orthopedics 2017: 7:180-91.","journal-title":"Open Journal of Orthopedics"},{"key":"ref14","first-page":"47","article-title":"Biomechanical analysis of plate systems for proximal humerus fractures: a systematic literature review","author":"AJabranA","year":"2018","unstructured":"Jabran A, Peach C, Ren L. Biomechanical analysis \nof plate systems for proximal humerus fractures: a \nsystematic literature review. Biomed Eng Online \n2018; 17:47.","journal-title":"Biomed Eng Online"},{"key":"ref15","first-page":"1939","article-title":"Locking plate and fibular allograft augmentation in unstable fractures of proximal humerus","author":"FMatassiF","year":"2012","unstructured":"Matassi F, Angeloni R, Carulli C, Civinini R, Di \nBella L, Redl B, Innocenti M. Locking plate and fi-\nbular allograft augmentation in unstable fractures of \nproximal humerus. Injury 2012; 43:1939-42.","journal-title":"Injury"},{"key":"ref16","first-page":"298","article-title":"Grafting and fixation of proximal humeral aseptic non union: a prospective case series","author":"GRolloG","year":"2017","unstructured":"Rollo G, Rotini R, Pichierri P, Giaracuni M, Stasi A, \nMacchiarola L, Bisaccia M, Meccariello L. Grafting \nand fixation of proximal humeral aseptic non union: \na prospective case series. Clin Cases Miner Bone \nMetab 2017; 14:298-304.","journal-title":"Clin Cases Miner Bone Metab"},{"key":"ref17","first-page":"3245","article-title":"Establishment of a three-dimensional finite element model and biomechanical analysis of three different internal fixation methods for humeral greater tuberosity fracture","author":"SLongxiangS","year":"2018","unstructured":"Longxiang S, Wei Z, Qiuke W, Yunfeng C. Establis-\nhment of a three-dimensional finite element model \nand biomechanical analysis of three different inter-\nnal fixation methods for humeral greater tuberosity \nfracture. Int J Clin Exp Med 2018; 11:3245-54.","journal-title":"Int J Clin Exp Med"},{"key":"ref18","first-page":"2151458517750516","article-title":"Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient","author":"ASchumaierA","year":"2018","unstructured":"Schumaier A, Grawe B. Proximal Humerus \nFractures: Evaluation and Management in the El-\nderly Patient. Geriatr Orthop Surg Rehabil 2018; \n9:2151458517750516.","journal-title":"Geriatr Orthop Surg Rehabil"},{"key":"ref19","first-page":"1935","article-title":"Primary screw perforation or subsequent screw cut-out following proximal humerus fracture fixation using locking plates: a review of causative factors and proposed solutions","author":"TMcmillanT","year":"2018","unstructured":"McMillan TE, Johnstone AJ. Primary screw perfora-\ntion or subsequent screw cut-out following proximal \nhumerus fracture fixation using locking plates: a re-\nview of causative factors and proposed solutions. Int \nOrthop 2018; 42:1935-42.","journal-title":"Int Orthop"},{"key":"ref20","first-page":"18","article-title":"Osteosynthesis with locking plate and minimally invasive technique for proximal humeral fractures","author":"CArroyo-S\u00e1nchezC","year":"2017","unstructured":"Arroyo-S\u00e1nchez C, Abril-Gaona C, Rinc\u00f3n-Cardozo \nD. Osteosynthesis with locking plate and minimally \ninvasive technique for proximal humeral fractures. \nActa Ortop Mex 2017; 31:18-23.","journal-title":"Acta Ortop Mex"},{"key":"ref21","first-page":"1067","article-title":"An alternative technique for greater tuberosity fractures: use of the mesh plate","author":"YBogdanY","year":"2017","unstructured":"Bogdan Y, Gausden EB, Zbeda R, Helfet DL, Lorich \nDG, Wellman DS. An alternative technique for gre-\nater tuberosity fractures: use of the mesh plate. Arch \nOrthop Trauma Surg 2017; 137:1067-70.","journal-title":"Arch Orthop Trauma Surg"},{"key":"ref22","first-page":"50","article-title":"Operative repair of proximal humerus fractures in septuagenarians and octogenarians: Does chronologic age matter?","author":"AGochA","year":"2017","unstructured":"Goch AM, Christiano A, Konda SR, Leucht P, Egol \nKA. Operative repair of proximal humerus fractures \nin septuagenarians and octogenarians: Does chrono-\nlogic age matter? J Clin Orthop Trauma 2017; 8:50-3.","journal-title":"J Clin Orthop Trauma"},{"issue":"Suppl 5","key":"ref23","doi-asserted-by":"crossref","first-page":"32","DOI":"10.1097\/BOT.0000000000000721","article-title":"The clinical and economic impact of generic locking plate utilization at a Level II Trauma Center","author":"AMcphillamyA","year":"2016","unstructured":"Mcphillamy A, Gurnea TP, Moody AE, Kurnik CG, \nLu M. The clinical and economic impact of generic \nlocking plate utilization at a Level II Trauma Center. \nJ Orthop Trauma 2016; 30(Suppl 5):S32-6.","journal-title":"J Orthop Trauma"},{"key":"ref24","first-page":"287","article-title":"Displaced proximal humerus fractures: is a sling as good as a plate?","author":"MSteinhausM","year":"2016","unstructured":"Steinhaus ME, Dare DM, Gulotta LV. Displaced \nproximal humerus fractures: is a sling as good as a \nplate? HSS J 2016; 12:287-90.","journal-title":"HSS"},{"key":"ref25","article-title":"Treatment of proximal humeral fractures: a critical analysis review","author":"AJawaA","year":"2016","unstructured":"Jawa A, Burnikel D. Treatment of proximal humeral \nfractures: a critical analysis review. JBJS Rev 2016;","journal-title":"JBJS Rev"},{"key":"ref26","first-page":"336","article-title":"Significant differences between local reporting and central assessment of radiographic complications in a prospective, multicenter study about locking plate fixation of proximal humerus fractures","author":"SKathreinS","year":"2016","unstructured":"Kathrein S, Joeris A, Kralinger F, Blauth M, \nGoldhahn J. Significant differences between local \nreporting and central assessment of radiographic \ncomplications in a prospective, multicenter study \nabout locking plate fixation of proximal humerus \nfractures. J Orthop Trauma 2016; 30:e336-9.","journal-title":"J Orthop Trauma"},{"key":"ref27","first-page":"6211","article-title":"Least possible fixation techniques of 4-part valgus impacted fractures of the proximal humerus: a systematic review","author":"APanagopoulosA","year":"2016","unstructured":"Panagopoulos A, Tatani I, Ntourantonis D, Seferlis \nI, Kouzelis A, Tyllianakis M. Least possible fixation \ntechniques of 4-part valgus impacted fractures of the \nproximal humerus: a systematic review. Orthop Rev \n(Pavia) 2016; 8:6211.","journal-title":"Orthop Rev (Pavia)"},{"key":"ref28","first-page":"130","article-title":"Intramedullary nailing of the proximal humerus: evolution, technique, and results","author":"MDilisioM","year":"2016","unstructured":"Dilisio MF, Nowinski RJ, Hatzidakis AM, Fehringer \nEV. Intramedullary nailing of the proximal humerus: \nevolution, technique, and results. J Shoulder Elbow \nSurg 2016; 25:e130-8.","journal-title":"J Shoulder Elbow Surg"},{"key":"ref29","doi-asserted-by":"crossref","first-page":"909","DOI":"10.1016\/j.injury.2016.01.021","article-title":"Initial varus displacement of proximal humerus fractures results in similar function but higher complication rates","author":"CCapricciosoC","year":"2016","unstructured":"Capriccioso CE, Zuckerman JD, Egol KA. Initial \nvarus displacement of proximal humerus fractures \nresults in similar function but higher complication \nrates. Injury 2016; 47:909-13.","journal-title":"Injury"},{"key":"ref30","article-title":"Significant differences between local reporting and central assessment of radiological complications in a prospective, multicenter study about locking plate fixation of proximal humerus fractures","author":"SKathreinS","year":"2015","unstructured":"Kathrein S, Joeris A, Kralinger F, Blauth M, \nGoldhahn J. Significant differences between local \nreporting and central assessment of radiological \ncomplications in a prospective, multicenter study \nabout locking plate fixation of proximal humerus \nfractures. J Orthop Trauma 2015.","journal-title":"J Orthop Trauma"},{"key":"ref31","first-page":"345","article-title":"Operative vs. nonoperative treatment for comminuted proximal humeral fractures in elderly patients: a current meta-analysis","author":"JSongJ","year":"2015","unstructured":"Song JQ, Deng XF, Wang YM, Wang XB, Li X, Yu \nB. Operative vs. nonoperative treatment for commi-\nnuted proximal humeral fractures in elderly patients: \na current meta-analysis. Acta Orthop Traumatol Turc \n2015; 49:345-53.","journal-title":"Acta Orthop Traumatol Turc"},{"key":"ref32","first-page":"215","article-title":"Comparison of surgical versus non-surgical treatment of displaced 3-and 4-part fractures of the proximal humerus: a meta-analysis","author":"FMaoF","year":"2015","unstructured":"Mao F, Zhang DH, Peng XC, Liao Y. Comparison of \nsurgical versus non-surgical treatment of displaced \n3-and 4-part fractures of the proximal humerus: a \nmeta-analysis. J Invest Surg 2015; 28:215-24.","journal-title":"J Invest Surg"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1186\/s12891-015-0627-x","article-title":"A scoping review of biomechanical testing for proximal humerus fracture implants","author":"DCruickshankD","year":"2015","unstructured":"Cruickshank D, Lefaivre KA, Johal H, MacIntyre \nNJ, Sprague SA, Scott T, Guy P, Cripton PA, McKee \nM, Bhandari M, Slobogean GP. A scoping review of \nbiomechanical testing for proximal humerus fracture \nimplants. BMC Musculoskelet Disord 2015; 16:175.","journal-title":"BMC Musculoskelet Disord"},{"key":"ref34","first-page":"577","article-title":"Posttraumatic nonunions and malunions of the proximal humerus. Possibilities and limitations of corrective osteotomy","author":"RMellerR","year":"2015","unstructured":"Meller R, Hawi N, Schmiddem U, Millett PJ, Petri \nM, Krettek C. Posttraumatic nonunions and maluni-\nons of the proximal humerus. Possibilities and limi-\ntations of corrective osteotomy. Unfallchirurg 2015; \n118:577-85.","journal-title":"Unfallchirurg"}],"container-title":["Medicinski Glasnik"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/medicinskiglasnik.ba\/article\/145\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/medicinskiglasnik.ba\/article\/145\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T09:43:46Z","timestamp":1775468626000},"score":1,"resource":{"primary":{"URL":"https:\/\/medicinskiglasnik.ba\/article\/id\/115\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,5,10]]},"references-count":34,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,5,10]]},"published-print":{"date-parts":[[2019,5,10]]}},"URL":"https:\/\/doi.org\/10.17392\/1033-19","archive":["Internet Archive"],"relation":{"is-cited-by":[{"id-type":"doi","id":"10.2147\/IJGM.S354741","asserted-by":"object"}]},"ISSN":["1840-0132","1840-0132"],"issn-type":[{"value":"1840-0132","type":"electronic"},{"value":"1840-0132","type":"print"}],"subject":[],"published":{"date-parts":[[2019,5,10]]}}}