Treatment of proximal humeral fractures accompanied by medial calcar fractures using fibular autografts: A retrospective, comparative cohort study

Figure 1 The procedure of fibula autografting. A: Cutting of the skin and preparing to remove the fibular segment; B: The fibular segment is exposed and ready for removal; C: The remaining periosteum in the fibular segment is cleaned; D: The prepared fibular segment; E: The fibular segment is placed in the proximal humerus, and the haemostatic forceps point to the fibular segment implanted in the medullary cavity.

Figure 2 Radiographs of a typical case. A and B: Anteroposterior and lateral radiographs of the proximal humerus before surgery (orange arrow indicates the displaced humeral head); C and D: Anteroposterior and lateral radiographs of the proximal humerus after surgery; E and F: Anteroposterior radiographs of the tibia and fibula after removal of the fibular segment.

Figure 3 Computed tomography images of a typical case. A: Preoperative computed tomography (CT) image of the right proximal humerus in the horizontal position; B: Preoperative CT image of the right proximal humerus in the coronal position; C: Preoperative CT image of the right proximal humerus in the sagittal position; D: Three-dimensional CT image before reconstruction of the right proximal humerus; E: Postoperative CT image of the right proximal humerus in the horizontal position; F: Postoperative CT image of the right proximal humerus in the coronal position; G: Postoperative CT image of the right proximal humerus in the sagittal position; H: Three-dimensional CT image after reconstruction of the right proximal humerus.

Figure 4 Postoperative shoulder joint mobility in a typical case. A: Forward flexion and abduction of the shoulder joint at 12 mo after surgery; B: Adduction and internal rotation of the shoulder joint at 12 mo after surgery; C: Backward extension and external rotation of the shoulder joint at 12 mo after surgery; D: Backward extension and internal rotation of the shoulder joint at 12 mo after surgery.