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Related Concept Videos

Bones of the Upper Limb: Humerus01:19

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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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The ulna and radius are parallel bones of the antebrachium or the forearm. The ulna lies medially and consists of a bony tip called the olecranon process at its proximal end. This hook-like projection articulates with the olecranon fossa of the humerus and forms the "hinged" ulnohumeral part of the elbow joint. This joint facilitates forearm extension and flexion while preventing its hyperextension. Similarly, the coronoid process, another bony projection on the proximal/anterior side...
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The radius is longer of the two bones that make up the human antebrachium or forearm. At the proximal end, the radius articulates with the capitulum of the humerus and the radial notch of the ulna to form the elbow joint. At the distal end, the radius articulates with the ulna via the ulnar notch, forming the distal radioulnar joint. Distally, the radius also attaches to the carpal wrist bones (scaphoid and lunate) to form the radiocarpal joint.
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The muscles that move the forearms can be divided into four groups: forearm flexors, forearm extensors, forearm pronators, and forearm supinators. The flexors and extensors act on the elbow joint, while the pronators and supinators act on the radioulnar joints.
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The biceps brachii, brachialis, and brachioradialis are forearm flexors. The biceps brachii is made up of two heads. Its long head originates at the supraglenoid tubercle of the scapula, whereas that of the short head is...
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Geometry of Proximal Humerus Locking Plates.

Erik McDonald1, Dillon Kwiat, Utku Kandemir

  • 1Department of Orthopaedic Surgery, UCSF/SFGH Orthopaedic Trauma Institute, University of California, San Francisco, San Francisco, CA.

Journal of Orthopaedic Trauma
|July 14, 2015
PubMed
Summary

Different proximal humerus locking plates vary in screw placement and volume within the humeral head. Understanding these differences is crucial for optimizing fracture fixation and patient outcomes.

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Area of Science:

  • Orthopedic surgery
  • Biomedical engineering
  • Implant design

Background:

  • Proximal humerus fractures are common injuries.
  • Open reduction and internal fixation with periarticular locking plates is a standard treatment.
  • Plate geometry and screw placement significantly influence biomechanical stability.

Purpose of the Study:

  • To compare screw distribution, bone-screw interface, and screw volume within the humeral head for various locking plates.
  • To evaluate the impact of screw length (short of the articular surface) on these parameters.

Main Methods:

  • Seven manufacturers' locking plates were tested on foam humerus models.
  • A 3D motion tracking system digitized screw trajectories.
  • Calculated bone-screw interface, screw volume, and volume reduction when screws are shortened.

Main Results:

  • Biomet offered the greatest bone-screw interface; Zimmer had the least.
  • Synthes plate had the largest screw volume (31.5%); Smith & Nephew and Zimmer had the lowest.
  • Shortening screws by 15mm maximally reduced volume for Depuy (50%) and minimally for Synthes (29%).

Conclusions:

  • Significant variations exist in proximal humerus locking plate designs.
  • Clinicians must understand how plate configuration and screw trajectory impact biomechanical performance.
  • Optimizing screw selection and placement is key for effective fracture stabilization.