Complication management in operative treatment of humeral head fractures

The surgical treatment of proximal humeral head fractures is becoming increasingly more important and therefore represents an increasing challenge in traumatology. Specific knowledge of the most common complications and their management with an appropriate approach and implants is needed to avoid poor outcome for patients. Intraoperative complications can be differentiated from postoperative complications. Challenging and inadequate reduction in varus or valgus dislocated fractures, especially in osteoporotic bone, poor implant placement with intra-articular screws and bone cement perforation are described. Possible pitfalls and how to avoid them with intraoperative strategies are shown in detail. Infections, avascular humeral head necrosis, resorption of the tubercle, notching and luxation of shoulder arthroplasty are further postoperative complications. Pitfalls, their avoidance and options for correction are described in order to enable the best possible treatment of these fractures.