Proximal humeral fractures

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Proximal humeral fractures will likely continue to be an important area of discussion and study in the future because optimal treatment strategies remain unclear in many situations. The PROFHER trial in particular has generated much debate with respect to the treatment of displaced proximal humeral fractures, and this is likely a discussion that will continue for many years to come. Open reduction and internal fixation with locked plating through either a deltopectoral or deltoid splitting approach, with or without fibular strut grafting or other augmentation, will likely continue to be a frequent form of treatment for displaced two- and three-part fractures and even in four-part fractures in younger patients with good bone stock. Reverse total shoulder arthroplasty has been increasingly used for more complex fractures and for those with poor bone quality. Although initial results are promising, future studies would be beneficial to further elucidate long-term outcomes for this treatment strategy.

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