Background

Although locking plates generally have been considered the preferred treatment option for proximal humerus fracture fixation, intramedullary nailing of these fractures has been shown to yield similar results. The nail affords less surgical dissection about the fracture and may preserve humeral head viability. It also acts as a lateral buttress to varus collapse in patients with an intact greater tuberosity.

Purpose

This video describes the indications and technique for surgical fixation of a two-part proximal humerus fracture with the use of a short proximal humerus nail.

Methods

The anatomy, physical examination, diagnosis, and treatment options for a two-part proximal humerus fracture are reviewed. Surgical fixation in the form of intramedullary nailing with the use of a short proximal humerus nail is shown. The case presentation of a 55-year-old right hand–dominant woman with a two-part proximal humerus fracture treated via a short proximal humerus nail is reviewed.

Results

Postoperative clinical outcomes included good range of motion and return to activity. Current studies demonstrate no difference in the functional outcomes between two- and three-part proximal humerus fractures managed via an intramedullary nail or a locking plate.

Conclusion

Intramedullary nailing of two- and three-part proximal humerus fractures affords reliable fracture fixation and restoration of function.