كسر الطرف القريب من عظمة العضد في المرضى الذين تبلغ أعمارهم 65 عامًا أو أصغر مع أنماط الكسر المنزاح أو المعقد

References

• Younger individuals, however, have stronger bones & fixation provides a stable construct during fracture healing.
• They have significantly more demands from their shoulder function too.
• Dislocated head.
• Head facing superiorly/posteriorly (though in the socket, but not facing the glenoid).
• Splitting of head.
• GT is lying above the humeral head or displaced posteriorly.
• Significant varus angulation of the head (usually indicates severe medial pillar instability & progressive malposition).
• Minor displacement of GT, minimal head shaft angulation only in young and high demand individuals.
• Fractures of neck needing an ORIF are best fixed with locking plates and screws.
• It is also an implant of choice in displaced 3 & 4 part fractures.
• Every attempt must be made to reconstruct proximal humerus (even in split or dislocated head), particularly in younger patients.
• The crux of PHF surgery is to bring back the fractured GT in its anatomical position, to achieve satisfactory rotator cuff function.
• Sufficient time must be spent to identify, tag and repair the GT.
• Suture bites must be taken from the bone-tendon junction (not thru the bone).
• Nonunion of GT is the most frequent cause of inability to lift arm.