Proximal humeral fractures revisited

Although 80% of proximal humeral fractures can be managed fairly easily, 20% are significantly displaced and difficult to analyze and treat. The four-segment classification of proximal humeral fractures allows the fracture to be understood and described intelligently, provides a guide to treatment, and helps the physician to make early prognostic judgments. Plain radiographs, tomography, and/or CT scanning allows an individual case to be fitted into the classification scheme. Treatment (non-operative or operative) depends on the degree of displacement of the four major segments, whether the humeral articular surface is involved, and whether the glenohumeral joint is dislocated. Follow-up care and rehabilitation are extremely important for an optimum final outcome.