General considerations

C3.1 fractures (isolated anatomical neck fractures associated with glenohumeral dislocation) are very rare. The dislocation needs to be reduced as soon as possible, in an attempt to preserve the viability of the humeral head and neurological integrity. Typically, reduction should be done open with muscle relaxing anesthesia. This procedure is usually combined with an osteosynthesis. If attempted as a closed reduction remember that this may be unsuccessful with need for an open procedure. All treatment options for C3.1 fractures carry the high risk of avascular necrosis.

Operative fixation is the preferred treatment. However, the decision for surgery should also include the functional demands of the patients, the presence of comorbidities, and the ability to undergo operative treatment.

Indications for hemiarthroplasty are inability to achieve satisfactory reduction and stable fixation, especially in elderly patients with osteoporotic bone.