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J Am Acad Orthop Surg, Vol 15, No 1, January 2007, 12-26.
© 2007 the American Academy of Orthopaedic Surgeons
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Innovations in the Management of Displaced Proximal Humerus Fractures

Shane J. Nho, MD, Robert H. Brophy, MD, Joseph U. Barker, MD, Charles N. Cornell, MD and John D. MacGillivray, MD

Dr. Nho is Resident, Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY. Dr. Brophy is Resident, Department of Orthopaedic Surgery, Hospital for Special Surgery. Dr. Barker is Resident, Department of Orthopaedic Surgery, Hospital for Special Surgery. Dr. Cornell is Attending Orthopaedic Surgeon, Department of Orthopaedic Surgery, Hospital for Special Surgery. Dr. MacGillivray is Assistant Attending Orthopaedic Surgeon, Department of Orthopaedic Surgery, Hospital for Special Surgery.

None of the following authors or the departments with which they are affiliated has received anything of value from or owns stock in a commercial company or institution related directly or indirectly to the subject of this article: Dr. Nho, Dr. Brophy, Dr. Barker, Dr. Cornell, and Dr. MacGillivray.

Reprint requests: Dr. MacGillivray, Department of Orthopaedic Surgery, Hospital for Special Surgery, 535 East 70th Street, New York, NY 10021.

The management of displaced proximal humerus fractures has evolved toward humeral head preservation, with treatment decisions based on careful assessment of vascular status, bone quality, fracture pattern, degree of displacement, and patient age and activity level. The AO/ASIF fracture classification is helpful in guiding treatment and in stratifying the risk for associated disruption of the humeral head blood supply. Nonsurgical treatment consists of sling immobilization. For patients requiring surgery, options include closed reduction and percutaneous fixation; transosseous suture fixation; open reduction and internal fixation, with either conventional or locking plate fixation; bone graft; and hemiarthroplasty. Proximal humerus fractures must be evaluated on an individual basis, with treatment tailored according to patient and fracture characteristics.




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J. O. Anglen, M. T. Archdeacon, L. K. Cannada, and D. Herscovici Jr.
Avoiding Complications in the Treatment of Humeral Fractures
J. Bone Joint Surg. Am., July 1, 2008; 90(7): 1580 - 1589.
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S. J. Nho, R. H. Brophy, J. U. Barker, C. N. Cornell, and J. D. MacGillivray
Management of Proximal Humeral Fractures Based on Current Literature
J. Bone Joint Surg. Am., October 1, 2007; 89(suppl_3): 44 - 58.
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