Percutaneous fixation of valgus displaced fracture of the proximal humerus using a single screw

• Published in: Orthopaedics & traumatology, surgery & research Vol. 104; no. 1; pp. 67 - 70
• Main Authors: Gunst, S., Walch, G., Nové-Josserand, L.
• Format: Journal Article
• Language: English
• Published: France Elsevier Masson SAS 01-02-2018
• Subjects: Percutaneous fixation; Proximal humerus fracture; Valgus impacted fracture; Valgus impacted fracture; Proximal humerus fracture; Percutaneous fixation
• ISSN: 1877-0568; 1877-0568
• DOI: 10.1016/j.otsr.2017.11.006

Valgus-impacted proximal humerus fracture is a classic but rare entity in shoulder traumatology. Surgical treatment is controversial, with increasing use of minimally invasive techniques. Our technique uses a minimally invasive approach under fluoroscopic control. Raising the humeral head to reduce the valgus enables spontaneous and well-positioned reduction of the tuberosities and screw fixation between the greater tuberosity and the humeral shaft. Indications comprise valgus-impacted fracture without comminution of the medial epiphyseal-metaphyseal hinge or greater tuberosity; the rotator cuff contributes to reduction and must be intact. This type of fixation restores proximal humerus anatomy and achieves consolidation with low risk of secondary necrosis. Minimally invasive single-screw fixation is an alternative of choice for surgical treatment of valgus-impacted proximal humerus fracture.