Minimally invasive plate osteosynthesis can be reasonably considered for non-impacted surgical neck fractures.
A satisfactory reduction should be stabilized with K-wires before the plate is applied. Comminuted metaphyseal fractures may not be stable with K-wires. Using the plate as a reduction aid, perhaps adding a distractor as well, may be more effective.
Unless a satisfactory closed or minimally open reduction can be achieved, an open reduction should be employed.
Choose the approach best suited for planned reduction maneuvers or plate position.