Proximal humeral locking plates for displaced fractures of the proximal humeral humerus

Abstract

Many displaced proximal humeral fractures are amenable to open reduction and fixation with a proximal humeral locking plate. Critical to success of this technique are anatomic reduction of the humeral head, avoiding varus, tuberosity reduction so that its tip is just below the top of the head, placement of the plate so that its tip is below the tip of the tuberosity, and targeting screw placement into the regions of the humeral head with the documented highest bone mineral density and resistance to screw pullout. Delaying postoperative shoulder motion until at least 2Â weeks is essential for avoiding complications.