The Humeral Head Push-Pull Plate Technique: An Alternative Way to Stabilize the Humeral Head in Varus Angulated Proximal Humeral Fractures in the Elderly.

Despite the introduction of different surgical techniques and implants, osteoporotic varus displaced fractures of the proximal humerus treated with an angular stable plate have still a high risk of recurrence and/or screw penetration leading to revision surgery. Here, we describe a technique where we use an alternative approach to stabilize the humeral head by the use of apical subchondral bone anchors tightened to an angular stable plate. This technique eliminated the need for screws in the upper part of the humeral head, allowing the upper angular stable screws to be redirected to the inferomedial part of the humeral head. We named this technique the humeral head push-pull plate technique or H2P3 in its abbreviated form. The technique is presented in combination with a case series.