Internal fixation of proximal humeral fractures.
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.
Harrison
John W K
JW
Royal Bolton Hospital, Bolton, Lancashire, United Kingdom. jhbone@doctors.org.uk
Howcroft
Daniel W J
DW
Warner
James G
JG
Hodgson
Stephen P
SP
D015519:Bone Density / Q000502:physiology; D003952:Diagnostic Imaging; D004867:Equipment Design; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D004204:Joint Dislocations / Q000145:classification / Q000601:surgery; D010024:Osteoporosis / Q000150:complications; D011183:Postoperative Complications; D012784:Shoulder Fractures / Q000145:classification / Q000601:surgery*