The displaced greater tuberosity must be reduced and fixed stably. The metaphyseal fracture also requires reduction, usually provisional reduction with K-wires and, finally, stable plating.

Choose either the anterolateral or transdeltoid approach based on tuberosity fracture location.

Fractures with metaphyseal comminution should not be treated with minimally invasive plate osteosynthesis because exposure of the medial column is necessary for a stable reduction.

In the following procedure, we show the reduction and fixation for fractures involving the greater tuberosity. For specific details on reduction of the lesser tuberosity see Limited open reduction and preliminary fixation of lesser tuberosity and humeral head.