Complicated Fractures and Dislocations About the Shoulder Joint

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Abstract
1. Most fractures of the surgical neck of the humerus can be treated by a hanging cast or sling. Anatomical reduction of the fracture is not essential to obtain a good functional result. 2. Some fractures of the surgical neck, especially those associated with a fracture of the greater tuberosity with displacement, may require an open reduction. The method of open fixation is not limited to any one procedure. Either a blade plate, screws, staples, or an intramedullary pin may be most suitable. 3. Fractures of the greater tuberosity associated with a dislocation or with a fracture of the surgical neck of the humerus may require open reduction, particularly when the greater tuberosity fragment remains displaced after reduction. Open reduction is mandatory if the tuberosity fragment remains retracted under the acromion. 4. A fracture of the lesser tuberosity may be one of the diagnostic signs in posterior dislocation of the shoulder. 5. Fracture-dislocations of the shoulder are severe injuries which are difficult to treat. If closed reduction fails, open operation should be done. 6. The abduction method of treating fractures about the shoulder has limited use. The relaxed muscle position with the arm at the side is preferred as it gives much better functional results.

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