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Retrospective study comparing first- and new-generation proximal humerus locking plates in 152 proximal humerus
Xhulio Prifti1, Julien Chapleau2,3, Emilie Sandman2,3
1Centre Hospitalier d'Angoulême, Angoulême, France.
JSES Reviews, Reports, and Techniques
|July 2, 2026
Summary
A new-generation plate for proximal humerus fractures showed better stability and less displacement compared to the first-generation plate, improving patient outcomes in medium-term follow-up.
Area of Science:
- Orthopedic surgery
- Traumatology
- Radiology
Background:
- Proximal humerus fractures are common injuries requiring surgical intervention.
- Plate fixation is a standard treatment, with evolving implant designs aiming for improved outcomes.
- Comparing first-generation and new-generation plates is crucial for optimizing fracture management.
Purpose of the Study:
- To compare the stability and quality of reduction in proximal humerus fractures treated with first-generation versus new-generation plates.
- To evaluate radiological outcomes, including plate position and secondary displacement, between the two plate designs.
Main Methods:
- Retrospective cohort study of 152 patients with proximal humerus fractures treated between 2007 and 2023.
- Inclusion criteria: proximal humerus fractures treated with either plate type, with pre-operative, post-operative, and follow-up radiographs.
- Radiological measurements included neck-shaft angle, calcar displacement, greater tubercle height, humeral head offset, and plate position.
Main Results:
- No significant differences in age, smoking, follow-up duration, or initial reduction quality between groups.
- New-generation plates were positioned lower, indicating less varus collapse (11.4 mm vs. 15.2 mm at last follow-up, P < .001).
- First-generation plates showed significantly more secondary displacement of the neck-shaft angle (9.1° vs. 4.5°, P = .018).
Conclusions:
- New-generation plates offer acceptable positioning and reduced secondary humeral head displacement in the medium term.
- These findings suggest potential advantages of newer plate designs for proximal humerus fracture fixation.
- Further research may explore long-term functional outcomes associated with these implant differences.
