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BACKGROUND: The medial column fracture of the proximal humeral fracture is a type of fracture with high postoperative complications after internal fixation. Proximal humeral internal locking system is widely used in the proximal humeral fracture. The biomechanical stability of two different internal fixation models for the treatment of the poor medial column support proximal humeral fractures with proximal humeral internal locking system and proximal humeral internal locking system with fibular allograft augmentation is still unclear. OBJECTIVE: To investigate the biomechanical stability of the proximal humeral intemallocking system and proximal humeral internal locking system with fibular allograft augmentation in the poor medial column support proximal humeral fracture with finite element analysis, and to compare the difference in fixation modes in humeral calcar supporting screws under different fixing methods. METHODS: The proximal CT data of osteoporosis were obtained. According to the 5-mm osteotomy of the humerus, the posterior medial column of the humerus was established and divided into two groups. Group A was the proximal humeral internal locking system plate group, in which the A 1 group was placed in the proximal end of the plate, the A2 group was the E screw missing, the A3 group was the D screw missing; the 8 group received the proximal humeral intemallocking system plate combined with fibular allograft augmentation, and all screws was placed in the proximal end of the plate in the 81 group. In the 82 group, E screw was missing; in the 83 group, D screw was missing. The three-dimensional finite element method was used to analyze the biomechanical stability of different groups of models under indirect violence. RESULTS AND CONCLUSION: (1) In terms of structural stability, 8 group was significantly better than A group. The structural stability of A 1 group and A3 group of A group was comparable and better than that in A2 group. In 8 group, the structural stability of 81 group and 82 group was comparable and superior to 83 group. (2) For the poor medial column support proximal humeral fracture, the mechanical stability of the proximal humeral internal locking system plate combined with fibular allograft augmentation was better than that of the proximal humeral intemallocking system plate alone. When the fibular support was combined, the screw placement in the proximal end of the plate is optimal, and D screw has an important stabilizing effect on the support of the poor medial column support proximal humeral fracture. [ABSTRACT FROM AUTHOR]