- See:
three part Fracture:
- Discussion:
- includes large proximal fragment created by frx of
surgical neck of humerus;
- some capsular tissue is almost always retained on large head fragment
ensuring its viability;
- if head fragment is displaced anteriorly,
greater tuberosity is usually
frxed, whereas
lesser tuberosity is retained;
- frxed tuberosity segment is always displaced in a direction opposite
to the dislocation;
- in posterior fracture dislocation,
greater tuberosity is usually retained,
whereas the
lesser tuberosity is avulsed;
- Treatment:
- closed reduction w/ GEA to restore prox frag to anatomic position;
- if gross instability of frx remains after closed reduction of dislocation, then
ORIF is required;
- if reduction of the proximal fragment is blocked by soft tissue interposition, then
open reduction is manditory;
