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"https://www.academia.edu/login?post_login_redirect_url=https%3A%2F%2Fwww.academia.edu%2F25469223%2FNeer_Award_2006_Biomechanical_assessment_of_inferior_tuberosity_placement_during_hemiarthroplasty_for_four_part_proximal_humeral_fractures%3Fshow_translation%3Dtrue"; window.loswp.previewableAttachments = [{"id":45785456,"identifier":"Attachment_45785456","shouldShowBulkDownload":false}]; window.loswp.shouldDetectTimezone = true; window.loswp.shouldShowBulkDownload = true; window.loswp.showSignupCaptcha = false window.loswp.willEdgeCache = false; window.loswp.work = {"work":{"id":25469223,"created_at":"2016-05-19T14:13:58.619-07:00","from_world_paper_id":153336946,"updated_at":"2025-01-09T11:16:14.548-08:00","_data":{"ai_abstract":"Shoulder hemiarthroplasty is a standard treatment for displaced 4-part proximal humeral fractures, but its success in functional outcomes varies. Key technical concerns include restoring humeral head height and proper tuberosity positioning, with inferior malpositioning recognized as detrimental to recovery. This study investigates the biomechanical impact of inferior tuberosity placement on joint forces and positions during surgery, revealing significant alterations in glenohumeral forces under conditions of tuberosity displacement. Findings suggest correlations between inferior tuberosity positioning and limited motion and function in post-operative patients.","publication_date":"2008,,","publication_name":"Journal of Shoulder and Elbow Surgery"},"document_type":"paper","pre_hit_view_count_baseline":null,"quality":"high","language":"en","title":"Neer Award 2006: Biomechanical assessment of inferior tuberosity placement during hemiarthroplasty for four-part proximal humeral fractures","broadcastable":true,"draft":null,"has_indexable_attachment":true,"indexable":true}}["work"]; window.loswp.workCoauthors = [46160031,48867047,48989024]; window.loswp.locale = "en"; window.loswp.countryCode = "SG"; window.loswp.cwvAbTestBucket = ""; window.loswp.designVariant = "ds_vanilla"; window.loswp.fullPageMobileSutdModalVariant = "full_page_mobile_sutd_modal"; window.loswp.useOptimizedScribd4genScript = false; window.loginModal = {}; window.loginModal.appleClientId = 'edu.academia.applesignon'; window.userInChina = "false";</script><script defer="" src="https://accounts.google.com/gsi/client"></script><div class="ds-loswp-container"><div class="ds-work-card--grid-container"><div class="ds-work-card--container js-loswp-work-card"><div class="ds-work-card--cover"><div class="ds-work-cover--wrapper"><div class="ds-work-cover--container"><button class="ds-work-cover--clickable js-swp-download-button" data-signup-modal="{"location":"swp-splash-paper-cover","attachmentId":45785456,"attachmentType":"pdf"}"><img alt="First page of “Neer Award 2006: Biomechanical assessment of inferior tuberosity placement during hemiarthroplasty for four-part proximal humeral fractures”" class="ds-work-cover--cover-thumbnail" src="https://0.academia-photos.com/attachment_thumbnails/45785456/mini_magick20190211-27463-nb0iuk.png?1549894126" /><img alt="PDF Icon" class="ds-work-cover--file-icon" src="//a.academia-assets.com/images/single_work_splash/adobe_icon.svg" /><div class="ds-work-cover--hover-container"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span><p>Download Free PDF</p></div><div class="ds-work-cover--ribbon-container">Download Free PDF</div><div class="ds-work-cover--ribbon-triangle"></div></button></div></div></div><div class="ds-work-card--work-information"><h1 class="ds-work-card--work-title">Neer Award 2006: Biomechanical assessment of inferior tuberosity placement during hemiarthroplasty for four-part proximal humeral fractures</h1><div class="ds-work-card--work-authors ds-work-card--detail"><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="46160031" href="https://independent.academia.edu/JamesTibone"><img alt="Profile image of James Tibone" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />James Tibone</a><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="48867047" href="https://independent.academia.edu/RussellHuffman"><img alt="Profile image of Russell Huffman" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Russell Huffman</a><a class="ds-work-card--author js-wsj-grid-card-author ds2-5-body-md ds2-5-body-link" data-author-id="48989024" href="https://independent.academia.edu/JeremyGililland"><img alt="Profile image of Jeremy Gililland" class="ds-work-card--author-avatar" src="//a.academia-assets.com/images/s65_no_pic.png" />Jeremy Gililland</a></div><div class="ds-work-card--detail"><p class="ds-work-card--detail ds2-5-body-sm">2008, Journal of Shoulder and Elbow Surgery</p><div class="ds-work-card--work-metadata"><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">visibility</span><p class="ds2-5-body-sm" id="work-metadata-view-count">…</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">description</span><p class="ds2-5-body-sm">8 pages</p></div><div class="ds-work-card--work-metadata__stat"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">link</span><p class="ds2-5-body-sm">1 file</p></div></div><script>(async () => { const workId = 25469223; 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if (!viewCountBody) { throw new Error('Failed to find work views element'); } viewCountBody.textContent = `${commaizedViewCount} views`; } catch (error) { // Remove the whole views element if there was some issue parsing. document.getElementById('work-metadata-view-count')?.parentNode?.remove(); throw new Error(`Failed to parse view count: ${viewCount}`, error); } }; // If the DOM is still loading, wait for it to be ready before updating the view count. if (document.readyState === "loading") { document.addEventListener('DOMContentLoaded', () => { updateViewCount(viewCount); }); // Otherwise, just update it immediately. } else { updateViewCount(viewCount); } })();</script></div><p class="ds-work-card--detail ds2-5-body-md">AI-generated Abstract</p><p class="ds-work-card--work-abstract ds-work-card--detail ds2-5-body-md">Shoulder hemiarthroplasty is a standard treatment for displaced 4-part proximal humeral fractures, but its success in functional outcomes varies. Key technical concerns include restoring humeral head height and proper tuberosity positioning, with inferior malpositioning recognized as detrimental to recovery. This study investigates the biomechanical impact of inferior tuberosity placement on joint forces and positions during surgery, revealing significant alterations in glenohumeral forces under conditions of tuberosity displacement. Findings suggest correlations between inferior tuberosity positioning and limited motion and function in post-operative patients.</p><div class="ds-work-card--button-container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--work-card","attachmentId":45785456,"attachmentType":"pdf","workUrl":"https://www.academia.edu/25469223/Neer_Award_2006_Biomechanical_assessment_of_inferior_tuberosity_placement_during_hemiarthroplasty_for_four_part_proximal_humeral_fractures"}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--work-card","attachmentId":45785456,"attachmentType":"pdf","workUrl":"https://www.academia.edu/25469223/Neer_Award_2006_Biomechanical_assessment_of_inferior_tuberosity_placement_during_hemiarthroplasty_for_four_part_proximal_humeral_fractures"}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div><div class="ds-signup-banner-trigger-container"><div class="ds-signup-banner-trigger ds-signup-banner-trigger-control"></div></div><div class="ds-signup-banner ds-signup-banner-control"><div id="ds-signup-banner-close-button"><button class="ds2-5-button ds2-5-button--secondary ds2-5-button--inverse"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">close</span></button></div><div class="ds-signup-banner-ctas"><img src="//a.academia-assets.com/images/academia-logo-capital-white.svg" /><h4 class="ds2-5-heading-serif-sm">Sign up for access to the world's latest research</h4><button class="ds2-5-button ds2-5-button--inverse ds2-5-button--full-width js-swp-download-button" data-signup-modal="{"location":"signup-banner"}">Sign up for free<span class="material-symbols-outlined" style="font-size: 20px" translate="no">arrow_forward</span></button></div><div class="ds-signup-banner-divider"></div><div class="ds-signup-banner-reasons"><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Get notified about relevant papers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Save papers to use in your research</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Join the discussion with peers</span></div><div class="ds-signup-banner-reasons-item"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">check</span><span>Track your impact</span></div></div></div><script>(() => { // Set up signup banner show/hide behavior: // 1. 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The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"How the greater tuberosity affects clinical outcomes after reverse shoulder arthroplasty for proximal humeral fractures","attachmentId":120493126,"attachmentType":"pdf","work_url":"https://www.academia.edu/126646490/How_the_greater_tuberosity_affects_clinical_outcomes_after_reverse_shoulder_arthroplasty_for_proximal_humeral_fractures","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/126646490/How_the_greater_tuberosity_affects_clinical_outcomes_after_reverse_shoulder_arthroplasty_for_proximal_humeral_fractures"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="2" data-entity-id="92873866" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/92873866/Repositioning_of_the_humeral_tuberosities_can_be_guided_by_pectoralis_major_insertion">Repositioning of the humeral tuberosities can be guided by pectoralis major insertion</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="147065641" href="https://cgc.academia.edu/FannySilvestri">Fanny Silvestri</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Strategies in trauma and limb reconstruction (Online), 2014</p><p class="ds-related-work--abstract ds2-5-body-sm">In complex proximal humerus fractures, positioning of the tuberosities can be a challenge. This study demonstrates the constant angle between the pectoralis major (PM) and the medial lip of the bicipital groove (BG) on the horizontal axial plane. This angle can be used to determine the rotation, as well as the positioning of the tuberosities, when planning a hemiarthroplasty or a reconstruction. Thirty-one shoulder MRIs were reviewed by three independent observers. The measurements were taken by superposing the axial cut of the proximal humerus, at the level of the distal bicipital groove, and the cut at the top of the PM insertion. By aligning the centers of rotation, we could determine the arcs of rotation between the insertion of the PM and the lips of the medial and lateral bicipital groove (MBG and LBG). Both angles were compared in terms of reliability, reproducibility, and precision. The mean PM-MBG angle was 3.7° [standard deviation (SD) 14.7°] and 27.4° (SD 14.4°) for the P...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Repositioning of the humeral tuberosities can be guided by pectoralis major insertion","attachmentId":95768072,"attachmentType":"pdf","work_url":"https://www.academia.edu/92873866/Repositioning_of_the_humeral_tuberosities_can_be_guided_by_pectoralis_major_insertion","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/92873866/Repositioning_of_the_humeral_tuberosities_can_be_guided_by_pectoralis_major_insertion"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="3" data-entity-id="54334294" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/54334294/Shoulder_arthroplasty_for_the_treatment_of_the_sequelae_of_fractures_of_the_proximal_humerus">Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="144733982" href="https://independent.academia.edu/BoileauPascal">Pascal Boileau</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Shoulder and Elbow Surgery, 2001</p><p class="ds-related-work--abstract ds2-5-body-sm">categories of proximal humerus fracture sequelae: category 1, intracapsular/impacted fractures sequelae (associated with both cephalic collapse or necrosis [type 1] and chronic dislocation or fracture-dislocation [type 2]), in which an articulating joint can be reconstructed without a greater tuberosity osteotomy; and category 2, extracapsular/disimpacted fractures sequelae (associated with both surgical neck nonunions [type 3] and severe tuberosity malunions [type 4]) where the proximal humerus cannot be reconstructed without a greater tuberosity osteotomy. All of the excellent and good postoperative Constant scores were obtained in type 1 and 2, in which osteotomy of the greater tuberosity was not required. All patients in type 3 and 4, who underwent a greater tuberosity osteotomy, had either fair or poor results and did not regain active elevation above 90°. We conclude that a greater tuberosity osteotomy is the most likely reason for poor and unpredictable results after shoulder replacement arthroplasty for the treatment of the complex sequelae of proximal humerus fractures. Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus should be performed without an osteotomy of the greater tuberosity when possible. If prosthetic replacement is possible without an osteotomy, surgeons should accept the distorted anatomy of the proximal humerus and adapt the prosthesis and their technique to the modified anatomy. A modular and adaptable prosthesis with both adjustable offsets and inclination may allow surgeons to adapt to a large number of malunions and may help to avoid the troublesome greater tuberosity osteotomy in a higher proportion of cases.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Shoulder arthroplasty for the treatment of the sequelae of fractures of the proximal humerus","attachmentId":70748919,"attachmentType":"pdf","work_url":"https://www.academia.edu/54334294/Shoulder_arthroplasty_for_the_treatment_of_the_sequelae_of_fractures_of_the_proximal_humerus","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/54334294/Shoulder_arthroplasty_for_the_treatment_of_the_sequelae_of_fractures_of_the_proximal_humerus"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="4" data-entity-id="73121812" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/73121812/Prosthesis_Designs_and_Tuberosity_Fixation_Techniques_in_Reverse_Total_Shoulder_Arthroplasty_Influence_on_Tuberosity_Healing_in_Proximal_Humerus_Fractures">Prosthesis Designs and Tuberosity Fixation Techniques in Reverse Total Shoulder Arthroplasty: Influence on Tuberosity Healing in Proximal Humerus Fractures</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="49797947" href="https://independent.academia.edu/PaulBorbas">Paul Borbas</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Clinical Medicine</p><p class="ds-related-work--abstract ds2-5-body-sm">Reverse total shoulder arthroplasty (RTSA) is increasingly used for the treatment of complex proximal humerus fractures and fracture sequelae. In 2021, half a dozen models of fracture stems are commercially available, reflecting its growing utility for fracture management. Prosthesis designs, bone grafting and tuberosity fixation techniques have evolved to allow better and more reliable fixation of tuberosities and bony ingrowth. Patients with anatomical tuberosity healing not only have an increased range of active anterior elevation and external rotation, but also experience fewer complications and longer prosthesis survival. This review provides an overview of recent evidence on basic and fracture-specific RTSA design features as well as tuberosity fixation techniques that can influence tuberosity healing.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Prosthesis Designs and Tuberosity Fixation Techniques in Reverse Total Shoulder Arthroplasty: Influence on Tuberosity Healing in Proximal Humerus Fractures","attachmentId":81766568,"attachmentType":"pdf","work_url":"https://www.academia.edu/73121812/Prosthesis_Designs_and_Tuberosity_Fixation_Techniques_in_Reverse_Total_Shoulder_Arthroplasty_Influence_on_Tuberosity_Healing_in_Proximal_Humerus_Fractures","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/73121812/Prosthesis_Designs_and_Tuberosity_Fixation_Techniques_in_Reverse_Total_Shoulder_Arthroplasty_Influence_on_Tuberosity_Healing_in_Proximal_Humerus_Fractures"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="5" data-entity-id="113092743" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/113092743/Proximal_Humerus_Fracture_Dislocation_Look_for_the_Greater_Tuberosity">Proximal Humerus Fracture/Dislocation: Look for the Greater Tuberosity</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="249450357" href="https://independent.academia.edu/KarimAbdelghafour">Karim Abdelghafour</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Cureus, 2023</p><p class="ds-related-work--abstract ds2-5-body-sm">The shoulder is the commonest major joint involved in dislocations. These are often associated with fractures of the surgical neck and/or of the greater tuberosity of the proximal humerus. A good functional recovery is associated with a successful union of the tuberosity fragment, as this carries the insertion of the superior and posterior rotator cuff tendons. A 29-year-old male patient presented to our Emergency Department (ED) after a fall off his motorbike, resulting in a left shoulder fracture dislocation and an axillary nerve injury. His shoulder was reduced under sedation in the ED, with post-reduction radiographs demonstrating a seemingly satisfactory fracture position. Later on, a computerized tomography (CT) scan was arranged which actually confirmed significant displacement of his greater tuberosity, which was not picked up on initial post-reduction radiographs. As a result of identifying the displacement, surgical fixation with a locking plate and suture construct was undertaken. This case demonstrates the ease with which greater tuberosity fractures can mistakenly be presumed as reduced on post-reduction films, whilst in fact they can be significantly displaced. This risk is especially great when only one radiographic view is obtained. The sign of the 'disappearing tuberosity' on a plain radiograph should prompt the clinician to seek further imaging by way of CT, to uncover the true position of the greater tuberosity.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Proximal Humerus Fracture/Dislocation: Look for the Greater Tuberosity","attachmentId":110144508,"attachmentType":"pdf","work_url":"https://www.academia.edu/113092743/Proximal_Humerus_Fracture_Dislocation_Look_for_the_Greater_Tuberosity","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/113092743/Proximal_Humerus_Fracture_Dislocation_Look_for_the_Greater_Tuberosity"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="6" data-entity-id="73714595" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/73714595/Two_level_reconstruction_of_isolated_fracture_of_the_lesser_tuberosity_of_the_humerus">Two-level reconstruction of isolated fracture of the lesser tuberosity of the humerus</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="36575505" href="https://independent.academia.edu/VassiliosNikolaou">Vassilios Nikolaou</a></div><p class="ds-related-work--metadata ds2-5-body-xs">World journal of clinical cases, 2014</p><p class="ds-related-work--abstract ds2-5-body-sm">Fractures of the lesser tuberosity of the humerus are typically met in combination with other injuries of the shoulder. Case reports of isolated lesser tuberosity fractures are particularly rare and, consequently, therapeutic protocols have not yet been completely clarified. Conservative as well as surgical treatment has been recommended, while several operative techniques have been applied. We present a case of a 39-year-old man with an isolated lesser tuberosity fracture who was treated surgically in our institution. Due to fracture comminution, a two-level reconstruction technique with headless screws and buttress plate was applied. As far as we know, this method of fixation of this type of fracture has not been previously described in the literature. The patient tolerated the procedure well and excellent results were obtained at the latest follow-up.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Two-level reconstruction of isolated fracture of the lesser tuberosity of the humerus","attachmentId":82127798,"attachmentType":"pdf","work_url":"https://www.academia.edu/73714595/Two_level_reconstruction_of_isolated_fracture_of_the_lesser_tuberosity_of_the_humerus","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/73714595/Two_level_reconstruction_of_isolated_fracture_of_the_lesser_tuberosity_of_the_humerus"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="7" data-entity-id="109890245" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/109890245/A_Biomechanical_Study_of_Tuberosity_Based_Locked_Plate_Fixation_Compared_with_Standard_Proximal_Humeral_Locking_Plate_Fixation_for_3_Part_Proximal_Humeral_Fractures">A Biomechanical Study of Tuberosity-Based Locked Plate Fixation Compared with Standard Proximal Humeral Locking Plate Fixation for 3-Part Proximal Humeral Fractures</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="41046498" href="https://asu.academia.edu/PauloCastaneda">Paulo Castaneda</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Orthopaedic Trauma, 2020</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: One of the main shortcomings of current proximal humeral plate designs is their inability to reliably secure the greater tuberosity (GT) or lesser tuberosity, leading to fixation failure, nonunion, and rotator cuff dysfunction. Traditional proximal humeral locking plates (PHLPs) rely on isolated screw fixation or suture repair to maintain reduction of the greater and/or lesser tuberosities. This study evaluates a tuberosity-based plate (TBP) specifically designed to improve tuberosity fixation, which may decrease tuberosity displacement and related clinical sequelae. Methods: Five cadaveric specimens (10 shoulders) were randomized to receive either standard PHLP or TBP fixation. The specimens were skeletonized except for the rotator cuff insertion on the GT. A reproducible 3-part osteotomy was performed for each cadaver, creating head, shaft, and GT segments. Anatomic reduction and plate fixation were performed according to the surgical technique guide for each plate sys...</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"A Biomechanical Study of Tuberosity-Based Locked Plate Fixation Compared with Standard Proximal Humeral Locking Plate Fixation for 3-Part Proximal Humeral Fractures","attachmentId":107877962,"attachmentType":"pdf","work_url":"https://www.academia.edu/109890245/A_Biomechanical_Study_of_Tuberosity_Based_Locked_Plate_Fixation_Compared_with_Standard_Proximal_Humeral_Locking_Plate_Fixation_for_3_Part_Proximal_Humeral_Fractures","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/109890245/A_Biomechanical_Study_of_Tuberosity_Based_Locked_Plate_Fixation_Compared_with_Standard_Proximal_Humeral_Locking_Plate_Fixation_for_3_Part_Proximal_Humeral_Fractures"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="8" data-entity-id="124058232" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/124058232/Tuberosity_healing_after_reverse_shoulder_arthroplasty_for_complex_proximal_humeral_fractures_in_elderly_patients_does_it_improve_outcomes_A_systematic_review_and_meta_analysis">Tuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients—does it improve outcomes? A systematic review and meta-analysis</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="115704630" href="https://independent.academia.edu/syedmannan5">syed mannan</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Shoulder and Elbow Surgery, 2019</p><p class="ds-related-work--abstract ds2-5-body-sm">Background: Reverse shoulder arthroplasty has seen increased use for management of complex proximal humeral fractures in the elderly. Recent evidence has shown that tuberosity healing leads to improved active range of motion and functional outcomes. The purpose of this study was to report on the radiographic and clinical outcomes of a consecutive series of patients having undergone reverse shoulder arthroplasty for fracture utilizing the ''black and tan'' methodda hybrid cementation-impaction grafting technique that uses autogenous cancellous bone graft to create an interface between the proximal cement mantle and the area of tuberosity repair. Methods: Twenty-five patients (average age, 77 years; range, 63-88 years) were included in the analysis with a mean follow-up of 17 months. All patients underwent reverse shoulder arthroplasty for a complex proximal humerus fracture using the black and tan technique. Results: The tuberosity healing rate was 88%. At final follow-up, mean active elevation was 117 AE 23 , mean abduction was 86 AE 16 , and mean external rotation was 29 AE 18. External rotation strength averaged 4.9 AE 0.2. The Simple Shoulder Test and Single Assessment Numeric Evaluation scores averaged 7 and 76, respectively. The mean American Shoulder and Elbow Surgeons total score was 71; visual analog scale score for pain, 2; and visual analog scale score for function, 7. Of the 25 patients, 21 (84%) rated their satisfaction with the surgery as excellent or good. Conclusions: The black and tan technique together with standard suture repair and an implant with features that support tuberosity repair results in a high tuberosity healing rate with restoration of external rotation after reverse shoulder arthroplasty for fracture.</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Tuberosity healing after reverse shoulder arthroplasty for complex proximal humeral fractures in elderly patients—does it improve outcomes? A systematic review and meta-analysis","attachmentId":118354003,"attachmentType":"pdf","work_url":"https://www.academia.edu/124058232/Tuberosity_healing_after_reverse_shoulder_arthroplasty_for_complex_proximal_humeral_fractures_in_elderly_patients_does_it_improve_outcomes_A_systematic_review_and_meta_analysis","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/124058232/Tuberosity_healing_after_reverse_shoulder_arthroplasty_for_complex_proximal_humeral_fractures_in_elderly_patients_does_it_improve_outcomes_A_systematic_review_and_meta_analysis"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-wsj-grid-card" data-collection-position="9" data-entity-id="19148753" data-sort-order="default"><a class="ds-related-work--title js-wsj-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/19148753/Isolated_tuberosity_fractures_of_the_proximal_humerus_Current_concepts">Isolated tuberosity fractures of the proximal humerus: Current concepts</a><div class="ds-related-work--metadata"><a class="js-wsj-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="39346027" href="https://independent.academia.edu/DavidRuchelsman">David Ruchelsman</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Injury, 2008</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Isolated tuberosity fractures of the proximal humerus: Current concepts","attachmentId":40458207,"attachmentType":"pdf","work_url":"https://www.academia.edu/19148753/Isolated_tuberosity_fractures_of_the_proximal_humerus_Current_concepts","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-wsj-grid-card-view-pdf" href="https://www.academia.edu/19148753/Isolated_tuberosity_fractures_of_the_proximal_humerus_Current_concepts"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div></div></div><div class="ds-sticky-ctas--wrapper js-loswp-sticky-ctas hidden"><div class="ds-sticky-ctas--grid-container"><div class="ds-sticky-ctas--container"><button class="ds2-5-button js-swp-download-button" data-signup-modal="{"location":"continue-reading-button--sticky-ctas","attachmentId":45785456,"attachmentType":"pdf","workUrl":null}">See full PDF</button><button class="ds2-5-button ds2-5-button--secondary js-swp-download-button" data-signup-modal="{"location":"download-pdf-button--sticky-ctas","attachmentId":45785456,"attachmentType":"pdf","workUrl":null}"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">download</span>Download PDF</button></div></div></div><div class="ds-below-fold--grid-container"><div class="ds-work--container js-loswp-embedded-document"><div class="attachment_preview" data-attachment="Attachment_45785456" style="display: none"><div class="js-scribd-document-container"><div class="scribd--document-loading js-scribd-document-loader" style="display: block;"><img alt="Loading..." src="//a.academia-assets.com/images/loaders/paper-load.gif" /><p>Loading Preview</p></div></div><div style="text-align: center;"><div class="scribd--no-preview-alert js-preview-unavailable"><p>Sorry, preview is currently unavailable. You can download the paper by clicking the button above.</p></div></div></div></div><div class="ds-sidebar--container js-work-sidebar"><div class="ds-related-content--container"><h2 class="ds-related-content--heading">Related papers</h2><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="0" data-entity-id="14699277" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/14699277/Posttraumatic_changes_of_the_proximal_humerus_Malunion_nonunion_and_osteonecrosis_Treatment_with_modular_hemiarthroplasty_or_total_shoulder_arthroplasty">Posttraumatic changes of the proximal humerus: Malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="33650183" href="https://independent.academia.edu/RussellWarren1">Russell Warren</a></div><p class="ds-related-work--metadata ds2-5-body-xs">Journal of Shoulder and Elbow Surgery, 1993</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Posttraumatic changes of the proximal humerus: Malunion, nonunion, and osteonecrosis. Treatment with modular hemiarthroplasty or total shoulder arthroplasty","attachmentId":43965371,"attachmentType":"pdf","work_url":"https://www.academia.edu/14699277/Posttraumatic_changes_of_the_proximal_humerus_Malunion_nonunion_and_osteonecrosis_Treatment_with_modular_hemiarthroplasty_or_total_shoulder_arthroplasty","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/14699277/Posttraumatic_changes_of_the_proximal_humerus_Malunion_nonunion_and_osteonecrosis_Treatment_with_modular_hemiarthroplasty_or_total_shoulder_arthroplasty"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="1" data-entity-id="33177367" data-sort-order="default"><a class="ds-related-work--title js-related-work-grid-card-title ds2-5-body-md ds2-5-body-link" href="https://www.academia.edu/33177367/Effect_of_displacement_of_fractures_of_the_greater_tuberosity_on_the_mechanics_of_the_shoulder">Effect of displacement of fractures of the greater tuberosity on the mechanics of the shoulder</a><div class="ds-related-work--metadata"><a class="js-related-work-grid-card-author ds2-5-body-sm ds2-5-body-link" data-author-id="64654966" href="https://uams.academia.edu/RegisRenard">Regis Renard</a></div><p class="ds-related-work--metadata ds2-5-body-xs">The Journal of Bone and Joint Surgery, 2001</p><div class="ds-related-work--ctas"><button class="ds2-5-text-link ds2-5-text-link--inline js-swp-download-button" data-signup-modal="{"location":"wsj-grid-card-download-pdf-modal","work_title":"Effect of displacement of fractures of the greater tuberosity on the mechanics of the shoulder","attachmentId":53261773,"attachmentType":"pdf","work_url":"https://www.academia.edu/33177367/Effect_of_displacement_of_fractures_of_the_greater_tuberosity_on_the_mechanics_of_the_shoulder","alternativeTracking":true}"><span class="material-symbols-outlined" style="font-size: 18px" translate="no">download</span><span class="ds2-5-text-link__content">Download free PDF</span></button><a class="ds2-5-text-link ds2-5-text-link--inline js-related-work-grid-card-view-pdf" href="https://www.academia.edu/33177367/Effect_of_displacement_of_fractures_of_the_greater_tuberosity_on_the_mechanics_of_the_shoulder"><span class="ds2-5-text-link__content">View PDF</span><span class="material-symbols-outlined" style="font-size: 18px" translate="no">chevron_right</span></a></div></div><div class="ds-related-work--container js-related-work-sidebar-card" data-collection-position="2" data-entity-id="86409279" data-sort-order="default"><a 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