Transcutaneous Reduction And Hoffmann External Fixation Of Displaced Fractures Of The Proximal Humerus:

Mohamed Hassan Mohamed Shoeir

SummaryProximal humeral fractures represent the most common humeralfractures (45%) In adults older than 40 years of age, the percentage ofproximal humeral fractures increases to 76%. Also, a higher incidence ofproximal humeral fractures was noted in women than in men, by a rate ofapproximately 2 to I. P.’roximal humeral fractures range in severity fromrelatively benign avulsion to massive fracture dislocations.The management of displaced fractures of the proximal humerus isstill under debate and the need to evaluate alternative methods has beenemphasized [Rose, 1982].There are many treatment options for management of displacedfractures of proximal humerus ..Closed reduction by manipulation is difficult to maintain because ofthe muscle action especially in displaced three or four part fractures.Temporary insertion of pins may be used to aid closed reduction, orthey may be left in situ for 4-6 weeks to hold the reduction. Open reductionand internal fixation has been used for proximal humeral fractures .Extensive soft tissue stripping may result from the use of buttress plates withpotential devascularization of the fracture fragments.Prosthetic replacement is considered in four-part fracture dislocationsor ..imp.r’ ession. ....frac.tu..r..es ~in.,”volvi.ng- -m.’ ..o- re.’. th”a’:-n- ”4.-00(:.0 of the- h’.e