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Principles

Introduction

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.

Deltopectoral approaches are best suited for lesser tuberosity reduction and fixation and plate application. Occasionally, an anterolateral approach provides sufficient access. For greater tuberosity fractures, a transdeltoid approach may provide easiest access.