Open reduction and angular stable plate osteosynthesis, if available, is the currently favored for A2 fractures.

Supporting indications

  • Unacceptable deformity
  • Need for more stability and/or earlier mobilization
  • Osteoporotic bone

Advantages

  • Earlier mobilization
  • No violation of the rotator cuff
  • Currently most stable fixation

Disadvantages

  • Technically demanding
  • Reduction must be nearly anatomical
  • Disimpaction causes instability, which fixation must overcome