General considerations

C3.2 fractures (glenohumeral dislocation associated with fractures of the anatomical neck and the tuberosities) are unusual injuries. The dislocation needs to be reduced as soon as possible in order to preserve the viability of the humeral head and neurological integrity. Doing so, this procedure is usually combined with an osteosynthesis. A closed reduction may be attempted but it is often unsuccessful. Thus the need for an open reduction and internal fixation must be remembered.

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. All treatment options for C3.2 fractures carry a high risk of avascular necrosis.

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