Operative treatment of two-part, displaced surgical neck fractures of the proximal humerus

Abstract

Operative treatment of two-part, displaced surgical neck fractures of the proximal humerus is used when satisfactory closed reduction cannot be achieved or maintained. Percutaneous pin stabilization is a reasonable option for unstable but reducible surgical neck fractures. When required, internal fixation is most reliably achieved with minimal hardware fixation, using heavy, nonabsorbable sutures or wire that incorporate the rotator cuff tendons, which are often stronger than the soft, osteoporotic bone. In cases with significant surgical neck comminution, humeral Enders nails may be incorporated into a tension-band construct for added longitudinal stability.