Proximal Humerus – Four-Part Fracture

Complex fractures of the proximal humerus, especially four-part fractures with valgus impingement, require technical expertise to restore anatomy and function.

This training presents, step by step, the reconstruction of the proximal humerus via the deltopectoral approach, with emphasis on the anatomical reduction of the tuberosities and stable fixation with a locking plate , demonstrated from a detailed surgical perspective .

Training Focus:

• Deltopectoral approach and identification of anatomical landmarks;
• Reduction of an impacted humeral head in valgus;
• Anatomical reduction of the tuberosities with controlled traction;
• Fixation with locking plate and screws for the heel;
• Reinforcement with FiberTape ties and bone graft (augmentation).

Detailed Content:

• Safe Anatomical Exposure: Strategic positioning and careful dissection preserving vital structures.
• Precise Release and Reduction: Techniques for repositioning an impacted head in valgus and realigning the tuberosities.
• Biomechanical Stability: Fixation with screws of the calcar and reinforcement with high-strength sutures.
• Bone Augmentation: A paste-like graft applied between the screw head to optimize structural support.
• Radiographic Control and Final Adjustments: Correction of shear and symmetry with screw repositioning.
• Fixation of the subscapularis to the plate: Improves rotational stability and facilitates a safe postoperative period.

Materials Included:

Detailed PDF: The supplementary material presents the complete protocol for proximal humerus reconstruction, focusing on the technique using the deltopectoral approach, anatomical reduction, valgus maneuvers, reinforcement with FiberTape, and the use of bone graft.

Enhance your technical skills in proximal humerus reconstruction.

Access the complete training now and improve your accuracy in trauma surgery.