European Journal of Molecular & Clinical Medicine

Abstract

Background:Proximal humerus fractures are one of the commonest fractures occurring in the
skeleton. They account for approximately 4 – 5% of the all fracture. The incidence of fracture of
the proximal humerus is bimodal in geriatric due to osteoporosis and in adolescents due to highenergy
trauma. A conservative treatment in a sling followed by functional rehabilitation under
supervision yields satisfactory results in minimally displaced fractures. The proximal humerus is
adapted to allow for the large range of motion of the shoulder joint. The proximal humerus
consists of the humeral head, the greater, lesser tuberosities, and shaft. The region of transition
between the articular cartilage and surrounding bone is defined as the anatomic neck and serves
as the site of attachment of the articular capsule, whereas the region immediately inferior to the
tuberosities is termed the surgical neck. The incidence of proximal humerus fractures is
increasing, especially in the elderly. Proximal humeral fractures account for 4% to 5% of all
fractures in adults and less than 1% of children's fractures. Approximately 3% of physeal
fractures occur through the proximal humerus.Operative management can consist of closed
reduction and percutaneous fixation, suture fixation, operative fixation with plate and screw
construct, or intramedullary fixation. The goals of operative fixation are to restore the anatomy of
the proximal humerus to allow for successful union, maximize function and early
rehabilitation.The articular surface’s relationship to the shaft must be restored to maximize range
of motion as well as stability. The tuberosities must also be reduced to their anatomical position
especially Isolated fractures of the greater tuberosity may be managed surgically even with less
displacement to maximize function of the arm by re-establishing the insertions of the rotator cuff