[Ortho] Prox humerus - перелом и вывых

[DR Tim Bray]

This is an anterior fracture/dislocation with shaft extension-no
chance for closed reduction-probably contraindicated, especially since
the injury is now 19 days old. We do these supine on a radiolucent
table with an arm board extension-you now have an unobstructed
radiographic view of the entire upper extremity both AP and lateral
with excellent axillary views of the glenohumeral joint to assess your
reduction and screw placement. This is the perfect indication for a
locking plate via the traditional deltopectoral approach. Use the
biceps tendon to stay anatomically oriented during the approach and be
sure to check the rotation post plate application. In general, we have
not performed any soft tissue stabilization procedures during the
fixation, may stay away from external rotation past neutral during
rehab and early motion protocol. This one should do fine.

 Bray, Althausen, O'mara- Reno