Executive Editor: Peter Trafton

Authors: Martin Jaeger, Frankie Leung, Wilson Li

Proximal humerus Extraarticular 3-part, surgical neck and lesser tuberosity, impaction

General considerations

In these fractures the blood supply to the humeral head is seldom totally disrupted, however, tuberosity malunion or nonunion, and secondary displacement can be problematic. Lesser tuberosity fractures are unusual, and indications for surgical repair are not clear. A significant lesser tuberosity displacement suggests subscapularis tendon avulsion. Operative repair, including tension band sutures for the tendon, may be necessary to preserve internal rotation strength and possibly shoulder stability as well.

Conservative treatment may also be considered and may achieve good results and is most appropriate for low-demand patients, if the shoulder is stable and subscapularis function is satisfactory.

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v2.0 2011-05-02