Open reduction with plate fixation is the currently favored technique for B1.1 and B1.3 fractures.

Supporting indications

  • Greater tuberosity displacement greater 5 mm
  • Unacceptable deformity
  • Need for more stability and/or earlier mobilization
  • Osteoporotic bone

Advantages

  • Best means of achieving satisfactory reduction and stable fixation
  • Earlier mobilization
  • No violation of the rotator cuff

Disadvantages

  • Technically demanding
  • Greater tuberosity reduction must be nearly anatomical, and preserved during plating
  • Disimpaction causes instability, which fixation must overcome