Surgical treatment of three-part proximal humeral fractures.

Published online: Jun 27 2001

De la Hoz Marín, Hernández Cortés, Tercedeor Sánchez,

Hospital Ciudad de Jaen, Jaén, Spain.


The majority of proximal humeral fractures may be managed with nonsurgical treatment. However, three-part displaced fractures require surgery with two goals: obtaining an anatomic reduction and providing enough stability to allow an early rehabilitation program. This article describes a simple technique of internal fixation with Kirschner wires that can be applied in fracture-dislocations and three-part fractures of the proximal humerus. A retrospective study of 29 consecutive cases of three-part fractures of the proximal humerus treated with this procedure is presented. Excellent or satisfactory results were achieved in 79.3% of cases using Neer's criteria at minimum 12 months follow-up. Eighteen patients (62.1%) had no pain or had only mild pain not interfering with daily activities. Twenty-four shoulders (75.9%) had more than 130 degrees active elevation, and 15 patients (51.7%) had at least 130 degrees active abduction. The complications were one avascular necrosis, one osteitis and one early loss of reduction that required a new operation. In conclusion we recommend this technique for operative treatment of three-part fractures of the humerus because of its simplicity and satisfactory results.