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Coronoid fractures occur as part of more complex injuries including other bone fractures (ie, radial head) and/or ligamentous injuries. Diagnostic tests include plain elbow x-rays and should include a computed tomographic scan. Indication for coronoid fixation is based on the fracture size and location, and factors related to the injury pattern and the severity of the instability. Fixation is performed when the fracture is big enough so as to be able to be repaired with solid hardware (screws and plates); small flecks of bone either do not need fixation, or, in cases of severe instability, other methods of stabilization should be chosen to render the elbow stable. Alternatives to fixation include the use of dynamic external fixators. Our preferred method of fixation includes posterior to anterior screw fixation performed open or arthroscopically, and open plate and screw fixation. Screws are used when there is a single big fragment or when one fragment contains the majority of the volume of the fractured coronoid. Arthroscopic fixation is very demanding technically, but much less invasive. Plates are used when coronoid comminution is present, and a buttress effect is needed, and when the sublime tubercle needs fixation. Surgical technique includes specific steps described in this article.

Determine the relative position of the main fractured fragments of proximal humerus fractures treated conservatively to compare displacement at 2 time points: injury (0), and 1 year later (1).

Introducción: La utilización de tornillos cementados en la fijación interna de fracturas de húmero proximal con placas bloqueadas parece mejorar la estabilidad del implante y disminuir las complicaciones asociadas al fracaso de síntesis. Sin embargo, la combinación óptima de tornillos cementados se desconoce. El objetivo de este estudio fue analizar la estabilidad relativa de dos configuraciones de tornillos cementados sometidos a una fuerza de compresión axial en una fractura simulada de húmero proximal.

Mayo-FJD classification for proximal humerus fractures aims to identify specific fracture patterns and apply displacement criteria to each pattern. The classification includes seven common fracture patterns: isolated fractures of the greater or lesser tuberosity, fractures of the surgical neck, impacted fractures involving head rotation in a varus and posteromedial direction or in valgus, and fractures where the humeral head is dislocated (head dislocation, split (head splitting) or depressed (head impaction). The purpose of this study was to evaluate the intra-observer and interobserver agreement of the Mayo-FJD classification system using plain radiographs (xR) and computed tomography (CT).

Multiple studies have reported an unacceptable implant-related complication rate in proximal humeral fractures treated with locking plates, particularly in older patients. Our objective was to compare the fracture fixation failure rates in elderly patients, after a dedicated technique for locking plate fixation with cement augmentation or without it.