{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,24]],"date-time":"2026-03-24T11:24:43Z","timestamp":1774351483773,"version":"3.50.1"},"reference-count":37,"publisher":"SLACK, Inc.","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthopedics"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:p>Proximal humerus fractures, although common, have high rates of failure after open reduction and internal fixation. The use of a fibular allograft has been explored as a means to decrease complications, particularly varus collapse and the need for revision surgery. The authors performed a retrospective review of 133 proximal humerus fractures managed surgically with locking plates (n=72) or locking plates with fibular allograft intramedullary struts (n=61). Demographic, intraoperative, and postoperative variables were collected and analyzed. The fibular allograft group was more likely to be older (<jats:italic>P<\/jats:italic>&lt;.01), be female (<jats:italic>P<\/jats:italic>=.04), and have a history of osteoporosis (<jats:italic>P<\/jats:italic>=.01). No differences were noted in the proportions of 2-, 3-, or 4-part fractures between groups. Average follow-up was 28 weeks. Medial calcar length was longer in the locking plate only group (<jats:italic>P<\/jats:italic>=.04); however, this group demonstrated a decreased head shaft angle (<jats:italic>P<\/jats:italic>=.01) and a trend toward increased rates of varus collapse (<jats:italic>P<\/jats:italic>=.06). No significant differences were found regarding other radiographic complications, irrespective of fracture complexity. A notable decrease in fluoroscopy time was seen with strut use (<jats:italic>P<\/jats:italic>=.04), but operative time and blood loss were similar between groups. A significant decrease in revision surgery rate was found with use of an allograft strut (<jats:italic>P<\/jats:italic>=.05). Using a strut appears to preserve the radiographic head shaft angle and decrease the risk of fracture collapse in 2-, 3-, and 4-part fractures, without increasing surgical time or morbidity. Use of an intramedullary strut appears to reduce the need for revision surgery, particularly in 3- and 4-part fractures. 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