الفهرس 
Anatomy of the shoulder joint.Only 14 pages are availabe for public view
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Abstract
Fractures of the proximal humerus can affect both elderly and young individuals causing serious disabilities and handicapping. While most of these fractures are minimally displaced and can be managed conservatively or by minimal interventions, the management of the more complex three and four parts fractures still remains a challenge.
The first step of appropriate management is an appropriate diagnosis. High quality imaging and thorough examination are very essential. Understanding the fracture pattern, the bone quality and taking in consideration the patient’s expectations and life style are crucial for a proper decision making.
The surgical management of displaced three and four part fractures of the proximal humerus in a surgically fit patient includes many options; two of the most commonly used are open reduction and internal fixation and shoulder hemiarthroplasty.
The decision to use either of these surgical modalities must depend on certain points. The most important points on which the surgeon can build his decision can be summarized as: the fracture type and pattern, the patient’s age, and the bone quality.
Proper surgical technique and precise application of the recommended surgical rules can save the patient from many intraoperative and postoperative complications.
The paramount importance of rehabilitation program can not be over emphasized. A well tailored and properly scheduled rehabilitation program is the corner stone for a successful management. Taking this concept to the patient is one of the surgeon’s most important tasks and unfortunately not the easiest one. A compliant and dedicated patient can encourage for more rapid advancement in the rehabilitation program and accordingly a better out come.
Even with the most meticulous surgical techniques, complications can not be completely avoided. Anticipation of complications, early discovery and proper management can decrease their devastating effect.