Biomechanical and clinical comparison of a novel dual-wing locking plate versus the PHILOS plate for neer three- and four-part proximal humeral fractures: a finite element analysis combined with a retrospective cohort study
Abstract
Background: Neer three- and four-part proximal humeral fractures treated with conventional PHILOS plating are associated with high complication rates, primarily due to tuberosity re-displacement and calcar screw cut-out. We developed a novel dual-wing locking plate featuring bilateral tuberosity-capturing wing extensions and an omnidirectional ball-head calcar screw. This study compared its biomechanical performance and clinical outcomes with those of the PHILOS plate.
Methods: A three-dimensional finite element model was reconstructed from CT data using Mimics 21.0, Geomagic 2021, and Rhino 7.0, and analyzed in ANSYS 2022R1 under four shoulder abduction angles (0°, 30°, 60°, 90°) with angle-specific physiological rotator cuff loading. Outcome measures included von Mises stress and displacement in the plate and bone, as well as implant stress distribution. Clinically, we reviewed 43 consecutive patients with Neer three- or four-part fractures treated between January 2023 and December 2024: 19 with the dual-wing plate (Group A) and 24 with the PHILOS plate (Group B). Recorded parameters included Visual Analog Scale score, Constant-Murley score shoulder range of motion, fracture union, and complications.
Results: Across all abduction angles, peak bone von Mises stress and maximum bone displacement were comparable between constructs (differences <2%). The principal biomechanical difference was stress distribution: the PHILOS plate concentrated peak stress at the proximal calcar…
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 43 participants or records.
Read the paper
Related studies
- A Survey on Knowledge Graphs: Representation, Acquisition, and Applications
- Toxicity of nanomaterials
- The Human Gene Mutation Database: towards a comprehensive repository of inherited mutation data for medical research, genetic diagnosis and next-generation sequencing studies
- Halogen bonding (X‐bonding): A biological perspective
- Biofilm formation at the air–liquid interface by the Pseudomonas fluorescens SBW25 wrinkly spreader requires an acetylated form of cellulose
- Opioid Activation of Toll-Like Receptor 4 Contributes to Drug Reinforcement
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.