Optimal stability for fixation of the anatomic neck in these fracture dislocations is probably provided by angular stable plates which should be considered for patients with better bone quality and limited comminution.
A deltopectoral approach is almost always required for glenohumeral reduction.
In these fractures there is a glenohumeral dislocation and a displaced anatomical neck fracture. In some cases, neurovascular compromise results from fracture fragment displacement. If this is the case, emergency treatment is necessary. Definitive reduction and fixation should not be long delayed, particularly if one wishes to salvage the humeral head. Hemiarthroplasty should be considered alternatively for elderly, infirm, and/or severely osteoporotic patients.
Closed reduction of the glenohumeral dislocation might be attempted. It is preferable to do this in the OR to permit conversion to an open reduction, if possible. This may avoid need for an additional anesthetic.