For complex proximal humeral fractures, most authors agree on the importance of anatomic reduction and stable fixation to allow early range of motion. Currently a variety of techniques are used such as K-wires, t-plates, and primary prosthesis among others. However, no current treatment guidelines have been established. Newer implants provide greater angular stability, better biomechanical properties, and enhanced anchorage in these complex injuries. These implants therefore have a potential for achieving better results in treating complex fractures. We discuss current treatment concepts and focus on biomechanics and early results of new implants designed to provide angular stability.
Level of evidence: Expert Opinion, Level V. See the Guidelines for Authors for a complete description of levels of evidence.