Internal fixation of valgus-impacted humeral head fractures using the screw-wiring technique

Between February 1996 and July 2000 eight patients (ages 35-74 years) with nine severely impacted humeral head fractures were operated on with the aim of preserving the humeral heads. Patients were treated surgically with open reduction, autologous bone grafting, and internal fixation with a screw-wiring technique. There were no complications and all patients were satisfied with the results. After 10-63 months there was no evidence of nonunion, arthritis, avascular necrosis, or loosening of implants. The mean Constant score was 83 (66-97) points. Results of this study support the observation that four-part valgus-impacted humeral head fractures without significant lateral displacement have a low incidence of avascular necrosis.