Proximal humeral fractures: pin, plate, or replace

Area of Science:

• Orthopedic surgery
• Geriatric medicine
• Traumatology

Background:

• Proximal humeral fractures are increasingly prevalent in individuals over 60.
• These fractures are the third most common fracture type in this demographic, following hip and distal radius fractures.
• While non-surgical management is often sufficient, surgical intervention is necessary for displaced or angulated fractures.

Purpose of the Study:

• To outline the primary surgical management strategies for proximal humeral fractures.
• To provide an overview of the available surgical options for treating these injuries.

Main Methods:

• Review of current surgical techniques for proximal humeral fracture fixation.
• Discussion of four principal surgical approaches: percutaneous fixation, plate fixation, hemiarthroplasty, and reverse total shoulder arthroplasty.

Main Results:

• Non-operative management is suitable for many proximal humeral fractures.
• Surgical intervention is indicated for specific fracture patterns, including displacement and significant angulation.
• Four distinct surgical options exist, each with its own indications and potential outcomes.

Conclusions:

• The choice of surgical treatment for proximal humeral fractures depends on fracture characteristics and patient factors.
• Minimally invasive fixation, open reduction with plating, hemiarthroplasty, and reverse total shoulder arthroplasty represent the spectrum of surgical care.
• Effective management requires careful consideration of these options to optimize patient recovery.