Abstract
Proximal humerus fractures are common injuries in the elderly.1 While most of these injuries are treated non-operatively with satisfactory results, surgical intervention is used for the more unstable fractures. Open reduction and internal fixation (ORIF) with plates is one available surgical option. Traditional plate osteosynthesis faced the problems of screw pull out from osteopenic metaphyseal bone. Various alternative techniques such as tension band wiring, suture fixation, intramedullary nailing and hemi-arthroplasty were designed to overcome problems of plate osteosynthesis with varying success. Fixed angled locking plates (FALPs) introduced in the late 1990s combine the advantages of locking plates with those of older, fixed-angle devices. These plates have reduced risks of screw pull they are ideal for osteopenic fractures.2 These plates are anatomically contoured to provide a template against which fractures can be reduced. They are expected to meet the challenges posed by the fracture pattern, the weak osteopenic bone, and the deforming forces around the shoulder. They also have eyelet holes to allow suture fixation of any displaced tuberosities.
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