Mini-incision fixation of proximal humeral four-part fractures

Abstract

Proximal humerus fractures are difficult to treat. Intraoperative fluoroscopic guidance is required to ensure appropriate anatomic reduction. Restoration of the anatomic relationship between the articular surface and the surrounding rotator cuff has a critical influence on the final result. Furthermore, fixation is a challenge to maintain as the rotator cuff exerts strong deforming forces on the tuberosities, which are often of poor bone quality and do not hold hardware well. In spite of this, many unstable proximal humerus fractures may be treated successfully with percutaneous fixation. Here we describe the indications, technique, and results of treatment with a minimally invasive approach for percutaneous fixation of proximal humerus fractures.