[New concepts for stabilizing proximal humeral fractures]

The treatment of proximal humerus fractures is overshadowed by problems like avascular humeral head necrosis, implant failure in osteopenic bone and moderate outcome, especially in the elderly. More precise imaging, a better understanding of the vascularity of the humeral head leading to indirect reduction techniques and new implants which allow for saver fixation even in osteopenic bone, allowing early functional aftercare, are the new promising factors which have the potential to ameliorate fracture treatment of the humeral head. A prerequisit for sucessful treatment is a thoroughful imaging which allows adequate preoperative planning. The type of stabilisation depends more on the surgeons preference and there are pros and cons with all implants. Functional after treatment however depends on the applied stabilisation principle and should be carefully monitored and adapted according to the bone healing process, monitored by regular postoperative x-ray controls.