{"id":{"repo_id":"aachen","oai_identifier":"oai:publications.rwth-aachen.de:51418"},"canonical_url":"https://search.dev.ndltd.org/etd/aachen/oai:publications.rwth-aachen.de:51418","repository":{"repo_id":"aachen","name":"RWTH Aachen University","base_url":"https://publications.rwth-aachen.de/oai2d"},"display":{"title":"Das DHS-Prinzip in der Versorgung proximaler Humerusfrakturen","abstract":"BACKGROUND: Despite the use of angular stable implants for proximal humeral fractures a lot of problems remain unsolved such as cutting out of screws, secondary displacement of the greater tubercle and the aim to minimize operative morbidity. This study analyses whether a plate using the DHS principle (H-DHS plate) may overcome these shortcomings. METHODS: In Phase A 8 intact enbalmed human cadaver shoulders received plate fixation in a minimally invasive technique. Humeri were then dissected by an independent examiner and the course of the axillary and radial nerve in relation to the implant were displayed. In Phase B a Neer IV/3 fracture was created with a 5 mm osteotomy gap simulating metaphyseal comminution. Limbs were randomly assigned to receive H-DHS plate fixation and on the contralateral limb Philos plate fixation before biomechanical evaluation (MTS-Bionix 858.2). FINDINGS: Submuscular positioning of the plate did not cause any damage to the axillary nerve, joint capsule or rotator cuff. With a mean stiffness of 300.9 +/- 28.8N/mm the H-DHS plate proved to be significantly stiffer than the Philos plate (184.2 +/- 23.4 N/mm; p=0.006). The H-DHS plate also resisted higher loads in terms of fixation failure with loss of reduction at 290 +/- 58.6N in comparison to 205 +/-8.6N for the Philos plate (p=0.2). Displacement of the greater tubercle occured in no case of the H-DHS group and in two out of four cases in the Philos group. INTERPRETATION: The H-DHS plate can be savely inserted in a minimally invasive technique and provides a high fixation stability in an in vitro humeral head fracture model.","abstract_html":"BACKGROUND: Despite the use of angular stable implants for proximal humeral fractures a lot of problems remain unsolved such as cutting out of screws, secondary displacement of the greater tubercle and the aim to minimize operative morbidity. This study analyses whether a plate using the DHS principle (H-DHS plate) may overcome these shortcomings. METHODS: In Phase A 8 intact enbalmed human cadaver shoulders received plate fixation in a minimally invasive technique. Humeri were then dissected by an independent examiner and the course of the axillary and radial nerve in relation to the implant were displayed. In Phase B a Neer IV/3 fracture was created with a 5 mm osteotomy gap simulating metaphyseal comminution. Limbs were randomly assigned to receive H-DHS plate fixation and on the contralateral limb Philos plate fixation before biomechanical evaluation (MTS-Bionix 858.2). FINDINGS: Submuscular positioning of the plate did not cause any damage to the axillary nerve, joint capsule or rotator cuff. With a mean stiffness of 300.9 +/- 28.8N/mm the H-DHS plate proved to be significantly stiffer than the Philos plate (184.2 +/- 23.4 N/mm; p=0.006). The H-DHS plate also resisted higher loads in terms of fixation failure with loss of reduction at 290 +/- 58.6N in comparison to 205 +/-8.6N for the Philos plate (p=0.2). Displacement of the greater tubercle occured in no case of the H-DHS group and in two out of four cases in the Philos group. INTERPRETATION: The H-DHS plate can be savely inserted in a minimally invasive technique and provides a high fixation stability in an in vitro humeral head fracture model.","abstract_has_math":false,"creators":["Gradl, Gertraud"],"institution":"Publikationsserver der RWTH Aachen University","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":["Pape, Hans-Christoph"],"advisors":[],"committee_chairs":[],"committee_members":[],"year":2009,"date_issued":"2009","date_published":"2009","updated_at":"2026-07-30T19:40:33Z","subjects":["info:eu-repo/classification/ddc/610","Biomechanik","Oberarmbruch","Osteosynthese","Anatomie","Medizin","proximale Humerusfraktur","humeral head fracture","plate","osteosynthesis","DHS","biomechanical testing","angular stability"],"languages":["ger"],"rights":["info:eu-repo/semantics/openAccess"],"rights_urls":[],"identifier_entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113710%22"],"render_values":[{"text":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113710%22","href":"https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113710%22","code":true}]}]},"links":{"outbound_url":"https://publications.rwth-aachen.de/record/51418","outbound_label":"Repository record","outbound_source":"dc:identifier"},"source_record":{"url":"https://publications.rwth-aachen.de/oai2d?verb=GetRecord&metadataPrefix=oai_dc&identifier=oai%3Apublications.rwth-aachen.de%3A51418","prefix":"oai_dc"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor","label":"Contributor","values":["Pape, Hans-Christoph"]},{"key":"dc:creator","label":"Author","values":["Gradl, Gertraud"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:coverage","label":"Dc Coverage","values":["DE"]},{"key":"dc:date","label":"Dc Date","values":["2009"]},{"key":"dc:publisher","label":"Institution","values":["Publikationsserver der RWTH Aachen University"]},{"key":"dc:relation","label":"Dc Relation","values":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-30707"]},{"key":"dc:type","label":"Dc Type","values":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["info:eu-repo/classification/ddc/610","Biomechanik","Oberarmbruch","Osteosynthese","Anatomie","Medizin","proximale Humerusfraktur","humeral head fracture","plate","osteosynthesis","DHS","biomechanical testing","angular stability"]}]},{"id":"language_rights","label":"Language and Rights","entries":[{"key":"dc:language","label":"Dc Language","values":["ger"]},{"key":"dc:rights","label":"Dc Rights","values":["info:eu-repo/semantics/openAccess"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier","label":"Identifier","values":["https://publications.rwth-aachen.de/record/51418","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113710%22"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description","label":"Description","values":["BACKGROUND: Despite the use of angular stable implants for proximal humeral fractures a lot of problems remain unsolved such as cutting out of screws, secondary displacement of the greater tubercle and the aim to minimize operative morbidity. This study analyses whether a plate using the DHS principle (H-DHS plate) may overcome these shortcomings. METHODS: In Phase A 8 intact enbalmed human cadaver shoulders received plate fixation in a minimally invasive technique. Humeri were then dissected by an independent examiner and the course of the axillary and radial nerve in relation to the implant were displayed. In Phase B a Neer IV/3 fracture was created with a 5 mm osteotomy gap simulating metaphyseal comminution. Limbs were randomly assigned to receive H-DHS plate fixation and on the contralateral limb Philos plate fixation before biomechanical evaluation (MTS-Bionix 858.2). FINDINGS: Submuscular positioning of the plate did not cause any damage to the axillary nerve, joint capsule or rotator cuff. With a mean stiffness of 300.9 +/- 28.8N/mm the H-DHS plate proved to be significantly stiffer than the Philos plate (184.2 +/- 23.4 N/mm; p=0.006). The H-DHS plate also resisted higher loads in terms of fixation failure with loss of reduction at 290 +/- 58.6N in comparison to 205 +/-8.6N for the Philos plate (p=0.2). Displacement of the greater tubercle occured in no case of the H-DHS group and in two out of four cases in the Philos group. INTERPRETATION: The H-DHS plate can be savely inserted in a minimally invasive technique and provides a high fixation stability in an in vitro humeral head fracture model."]},{"key":"dc:source","label":"Dc Source","values":["Aachen : Publikationsserver der RWTH Aachen University 91 S. : Ill., graph. Darst. (2009). = Aachen, Techn. Hochsch., Diss., 2009"]},{"key":"dc:title","label":"Title","values":["Das DHS-Prinzip in der Versorgung proximaler Humerusfrakturen"]}]}],"canonical_facts":{"dc:contributor":["Pape, Hans-Christoph"],"dc:coverage":["DE"],"dc:creator":["Gradl, Gertraud"],"dc:date":["2009"],"dc:description":["BACKGROUND: Despite the use of angular stable implants for proximal humeral fractures a lot of problems remain unsolved such as cutting out of screws, secondary displacement of the greater tubercle and the aim to minimize operative morbidity. This study analyses whether a plate using the DHS principle (H-DHS plate) may overcome these shortcomings. METHODS: In Phase A 8 intact enbalmed human cadaver shoulders received plate fixation in a minimally invasive technique. Humeri were then dissected by an independent examiner and the course of the axillary and radial nerve in relation to the implant were displayed. In Phase B a Neer IV/3 fracture was created with a 5 mm osteotomy gap simulating metaphyseal comminution. Limbs were randomly assigned to receive H-DHS plate fixation and on the contralateral limb Philos plate fixation before biomechanical evaluation (MTS-Bionix 858.2). FINDINGS: Submuscular positioning of the plate did not cause any damage to the axillary nerve, joint capsule or rotator cuff. With a mean stiffness of 300.9 +/- 28.8N/mm the H-DHS plate proved to be significantly stiffer than the Philos plate (184.2 +/- 23.4 N/mm; p=0.006). The H-DHS plate also resisted higher loads in terms of fixation failure with loss of reduction at 290 +/- 58.6N in comparison to 205 +/-8.6N for the Philos plate (p=0.2). Displacement of the greater tubercle occured in no case of the H-DHS group and in two out of four cases in the Philos group. INTERPRETATION: The H-DHS plate can be savely inserted in a minimally invasive technique and provides a high fixation stability in an in vitro humeral head fracture model."],"dc:identifier":["https://publications.rwth-aachen.de/record/51418","https://publications.rwth-aachen.de/search?p=id:%22RWTH-CONV-113710%22"],"dc:language":["ger"],"dc:publisher":["Publikationsserver der RWTH Aachen University"],"dc:relation":["info:eu-repo/semantics/altIdentifier/urn/urn:nbn:de:hbz:82-opus-30707"],"dc:rights":["info:eu-repo/semantics/openAccess"],"dc:source":["Aachen : Publikationsserver der RWTH Aachen University 91 S. : Ill., graph. Darst. (2009). = Aachen, Techn. Hochsch., Diss., 2009"],"dc:subject":["info:eu-repo/classification/ddc/610","Biomechanik","Oberarmbruch","Osteosynthese","Anatomie","Medizin","proximale Humerusfraktur","humeral head fracture","plate","osteosynthesis","DHS","biomechanical testing","angular stability"],"dc:title":["Das DHS-Prinzip in der Versorgung proximaler Humerusfrakturen"],"dc:type":["info:eu-repo/semantics/doctoralThesis","info:eu-repo/semantics/publishedVersion"]},"updated_at":"2026-07-30T19:40:33Z"}