Humeral Neck Fractures i n Association w ith Traumatic Shoulder Dislocation

Purpose: To evaluate the clinical and radiological outcomes of the open surgical management of concomitant neck humeral fractures and anterior glenohumeral dislocation with greater tuberosity fractures. Materials and methods: Twenty eight anterio r shoulder dislocations with greater tuberosity fracture in 28 patients were reviewed retrospectively. Out of them, 9 patients were found to have associated h umeral neck fractures (OTA/AO 11 - B3). Management of these patients consisted of open reduction and prophylactic fixation of the surgical neck fractures with proximal humeral plate. Results: Radiographic analysis included fracture reduction, stability of the fixation construct, and achievement of bony union and assessment of the femoral head avascular n ecrosis occurrence. Clinical outcomes were assessed by the shoulder range of motion, the presence of persistent shoulder pain and the occurrence of any post - operative complication that would necessitate intervention or deviation from the ordinary follow up . After a mean follow up of 19 months post - operative ; all the patients achieved bony union of the fracture with good clinical outcomes. None of the cases developed humeral head avascular necrosis. Satisfactory clinical results have been obtained in all of the nine cases. Conclusions: Early recognition of associate d humeral neck fractures in patients with anterior shoulder dislocation and greater tuberosity fracture can minimize the incide nce of iatrogenic fracture displacement. ORIF may offer a reasonable treatment option for such cases with lower incidence of complications.