Fractures of the proximal humerus

Background. Fractures of the proximal humerus are common in the daily clinical routine and remain a surgical challenge due to the complexity. In addition to conservative treatment different surgical options exist to treat these fractures. There is a trend towards operative treatment due to increasing functional demands even in elderly patients. Therapy. Until now no operative treatment option can be defined as being superior. Decisive for the outcome after osteosynthesis is anatomical reduction to reduce complication rates. If it is not possible to achieve primary reconstruction by osteosynthesis, primary fracture arthroplasty is indicated. The clinical results of anatomical fracture arthroplasty are dependent on correct healing of the tuberosities. In cases of rotator cuff insufficiency or fatty degeneration of the muscles, primary reversed fracture arthroplasty is the method of choice. Conclusion. The therapy is individual and depends on fracture morphology, patient-specific risk factors and patient requirements and expectations.