{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T21:59:58Z","timestamp":1775339998423,"version":"3.50.1"},"reference-count":0,"publisher":"AVES YAYINCILIK A.\u015e.","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["AOTT"],"abstract":"<jats:p>Abstract\n\n \n\nObjective: This finite element analysis aimed to examine the effect of medial cortical support and medial screw support on loads at the implant-bone interface of locking plate fixation of proximal humeral fractures with a medial gap.\n\n \n\nMethods: An intact humerus from a healthy volunteer was used as the basis for a 3-dimensional (3D) computer-aided design (CAD) model. The 3D CAD model of the locking plate system was based on information in the manufacturer\u2019s catalogue. The proximal part of the humerus was osteotomized to create standard three-part fractures, which were then divided into a \u2013MSC group (which lacked medial cortical support, and in which fractures with a 5-mm medial bone gap simulated this lack) and +MCS group (which had medial cortical support, and in which fractures with medial corticalto-cortical contact simulated this). Both fracture groups were respectively fixed with either +MSS (in which medial screw support was simulated by the addition of two calcar screws to the locking plate system), or with \u2013MSS (in which the lack of medial screw support was simulated by absence of the two additional calcar screws to the locking plate system). All the modeling was conducted to represent 90\u00b0 arm abduction.\n\n \n\nResults: On the screw-bone interface, medial screw support and medial cortical support decreased maximum shear stress by 17% and 23% respectively. On the locking plate, medial screw support and medial cortical support decreased maximum von Mises stress by 11% and 22% respectively. However,a combination of these two appeared to decrease maximum shear stress by 56% for the screw-bone interface, and maximum von Mises stress by 54% for the locking plate.\n\n \n\nConclusion: Placement of calcar screws combined with good medial cortical contact in varus in locking plate fixation of proximal humeral fractures with a medial gap may provide optimal stability for the fixation.\n\n \n\n \n\n\u00d6zet\n\n \n\nAma\u00e7: Bu sonlu elemanlar y\u00f6ntemi, medial a\u00e7\u0131kl\u0131\u011f\u0131 olan proksimal humerus k\u0131r\u0131klar\u0131n\u0131n implant-kemik ara y\u00fczeyindeki y\u00fcklerde medial kortikal ve medial vida desteklerinin etkisini ara\u015ft\u0131rmay\u0131 ama\u00e7lad\u0131.\n\n\u00c7al\u0131\u015fma plan\u0131: Sa\u011fl\u0131kl\u0131 bir g\u00f6n\u00fcll\u00fcden al\u0131nan sa\u011flam humerus 3 boyutlu (3D) bilgisayar-destekli tasar\u0131m (BDT) modelinde kaynak olarak kullan\u0131ld\u0131. Kilitli plak sisteminin 3D BDT modeli, \u00fcretici firman\u0131n k\u0131lavuzundaki bilgiler \u00fczerine kuruldu. Humerusun proksimal k\u0131sm\u0131, standart \u00fc\u00e7-par\u00e7a k\u0131r\u0131klar\u0131 yaratmak i\u00e7in osteotomize edildi ve sonra \u2013MKD grubu (medial kortikal deste\u011fi eksik ve bu eksiklik k\u0131r\u0131klarda 5 mm\u2019lik medial kemik a\u00e7\u0131kl\u0131\u011f\u0131 kaynakl\u0131) ve +MKD grubu (medial kortikal destek mevcut ve bu destek k\u0131r\u0131klarda kortikalden kortikale medial temas kaynakl\u0131) olarak ikiye ayr\u0131ld\u0131. Her iki k\u0131r\u0131k grubu ya +MVD (ki burada medial vida deste\u011fi kilitli plak sistemine ilave iki kalkar vidas\u0131 eklentisi ile sa\u011fland\u0131) ya da \u2013MVD (ki burada medial vida deste\u011fi eksikli\u011fi kilitli plak sistemine ilave iki kalkar vidas\u0131 eklenmemesi ile sa\u011fland\u0131) ile s\u0131ras\u0131yla onar\u0131ld\u0131. B\u00fct\u00fcn modelleme 90\u00b0\u2019lik kol abd\u00fcksiyonunu yans\u0131tmak i\u00e7in y\u00fcr\u00fct\u00fcld\u00fc.\n\nBulgular: Vida-kemik ara y\u00fczeyinde medial vida deste\u011fi ve medial kortikal destek maksimum kayma gerilimini s\u0131ras\u0131yla %17 ve %23 oran\u0131nda azaltt\u0131. Kilitli plak \u00fczerinde, medial vida deste\u011fi ve medial kortikal destek maksimum von Mises gerilimini s\u0131ras\u0131yla %11 ve %22 oran\u0131nda azaltt\u0131. Ancak, bu ikisinin kombinasyonunun vida-kemik ara y\u00fczeyi i\u00e7in maksimum kayma gerilimini %56 oran\u0131nda ve kilitli plak i\u00e7in maksimum von Mises gerilimini %54 oran\u0131nda azaltt\u0131\u011f\u0131 g\u00f6r\u00fcnd\u00fc.\n\n\u00c7\u0131kar\u0131mlar: Medial a\u00e7\u0131kl\u0131\u011f\u0131 olan proksimal humerus k\u0131r\u0131klar\u0131n\u0131n kilitli plak tespiti s\u0131ras\u0131nda varusta iyi medial kortikal temas ile bile\u015fik kalkar vida yerle\u015ftirilmesi tespit i\u00e7in optimal stabilite sa\u011flayabilir.<\/jats:p>","DOI":"10.3944\/aott.2015.14.0204","type":"journal-article","created":{"date-parts":[[2015,3,6]],"date-time":"2015-03-06T09:50:45Z","timestamp":1425635445000},"page":"203-209","source":"Crossref","is-referenced-by-count":13,"title":["Biomechanical effect of medial cortical support and medial screw support on locking plate fixation in proximal humeral fractures with a medial gap: a finite element analysis"],"prefix":"10.5152","volume":"49","author":[{"given":"Pan","family":"Yang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Min Ma","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chang","family":"Rong Zhu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3111","published-online":{"date-parts":[[2020,2,7]]},"container-title":["Acta Orthopaedica et Traumatologica Turcica"],"original-title":[],"link":[{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/download\/2965\/2918","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T11:09:45Z","timestamp":1763464185000},"score":1,"resource":{"primary":{"URL":"https:\/\/aott.org.tr\/index.php\/pub\/article\/view\/2965"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,2,7]]},"references-count":0,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2015,1,2]]}},"URL":"https:\/\/doi.org\/10.3944\/aott.2015.14.0204","relation":{},"ISSN":["2589-1294","1017-995X"],"issn-type":[{"value":"2589-1294","type":"electronic"},{"value":"1017-995X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,2,7]]}}}