Straining of the intact and fractured proximal humerus under physiological-like loading.

Surgical treatment of proximal humeral fractures remains challenging in elderly patients, primarily due to insufficient implant fixation. Both bone quality and physiological-like loading conditions are commonly overlooked during pre-clinical in vitro evaluation. However, this knowledge is necessary in order to improve surgical treatment of the proximal humerus and the mechanical behavior of implants, particularly in patients with complex fractures and weak bone stock.