Internal fixation of proximal humeral fractures

• Published in: Acta orthopaedica belgica Vol. 73; no. 1; pp. 1 - 11
• Main Authors: Harrison, John W K, Howcroft, Daniel W J, Warner, James G, Hodgson, Stephen P
• Format: Journal Article
• Language: English
• Published: Belgium 01-02-2007
• Subjects: Bone Density - physiology; Diagnostic Imaging; Equipment Design; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Humans; Joint Dislocations - classification; Joint Dislocations - surgery; Osteoporosis - complications; Postoperative Complications; Shoulder Fractures - classification; Shoulder Fractures - surgery
• ISSN: 0001-6462

We discuss the appropriate assessment and treatment options available for proximal humeral fractures. Important factors to consider are the fracture pattern, the bone quality and any co-morbidities. These are common injuries and are increasing in incidence due to an ageing population. The management of displaced 3- and 4-part fractures remains controversial. The ideal is anatomic reduction and stable internal fixation of the fractures especially the tuberosities to allow early mobilisation. The recent introduction of fixed angle locking plates allows stable fixation even in markedly osteoporotic bone. The early results are encouraging however there are presently no randomised trials comparing these devices to conservative treatment, conventional plating or hemiarthroplasty.