Fixed-angle locked plating of two-, three-, and four-part proximal humerus fractures

Open reduction and internal fixation with a locked plate is ideal for displaced two-part surgical neck fractures, two-part anatomic neck fractures in the patient younger than age 40 years, three-part surgical neck fractures with involvement of the greater or lesser tuberosity, and most four-part fractures. Locked plates allow for more secure fixation in compromised bone, thereby possibly leading to reduced incidence of hardware failure. Fracture-dislocations, however, are usually associated with high-energy injuries and are more prone to complications.