Proximal humerus fractures. Decisive factors for therapy choice, treatment and complications

The majority of proximal humerus fractures are treated conservatively resulting in satisfying results. Fractures which need to be treated operatively are challenging for the therapist, postoperative treatment and the patient. It is inadequate to establish a therapy concept only by using radiological images and the resulting classification. Factors which take the patient, the injury and the surgeon into consideration have to be included in the decision-making process. Operative reconstruction results in a high rate of complications. This could be the reason why even complex fractures are treated conservatively by some therapists, especially in older patients. Locking plates are used increasingly. Specific complications, such as primary or secondary screw perforation result in a high rate of revision surgery.