Related Experiment Video
Updated: May 15, 2026
Development of a Novel Internal Fixation Model for Rat Radial Fractures: Fracture Healing Assessment and Dorsal Root Ganglion Isolation
Published on: March 13, 2026
Outcomes of Internal Fixation in Proximal Humerus Head Split Fractures in Young Adults - How Often Is It Missed and
Kaustav Mukherjee1, Tarun Prashanth2, Dorai Kumar Raja2
1Department of Orthopaedics, Santiniketan Medical College and Hospital, Bolpur, West Bengal, India.
Introduction:
Humerus head-split fractures are a rare subgroup of proximal humerus fractures that are challenging to treat. Being a coronal plane fracture, they are often missed on standard shoulder radiographs. We aim to bring forward the difficulties in identifying the isolated head split fractures, modes of internal fixation, possible complications of missing the head-split component in a complex proximal humerus fracture fixation, and the outcomes on the functionality of the shoulder joint.
Materials And Methods:
A retrospective case-control study with all fractures treated by internal fixation was carried out at our institution. Shoulder axial computed tomography (CT) based Schiebel's classification, Type 1 (head-split with posterior subluxation), Type 2 (head-split with anterior subluxation), and Type 3 (head-split with impaction), was utilized to grade the fractures. Fixation included two groups: cancellous screws alone and a plate-augmented-screw construct. The control group included cases where head splits were not addressed appropriately. Functional and radiological analyses were done at regular follow-up visits.
Results:
A total of 24 patients were included in the study, 9 fixed by screws alone and 15 by plate-augmented-screw construct. The mean age of the study group was 34.5 years, with 85% male patients. Bony union was achieved in all cases, with the average time to union being 29 weeks. The study group recorded a mean Oxford shoulder score of 49 ± 2.45, contrary to the control group with a mean score of 22 ± 4.32 (P < 0.05).
Conclusion:
Simple head splits are easily missed on standard shoulder radiographs and need additional imaging/views for diagnosis. Schiebel Type 1 and 2 fractures recorded excellent functional outcomes when addressed appropriately.
Related Concept Videos
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:19Bones of the Upper Limb: Humerus