Surgical Discussion

Patient positioning:  The patient was positioned in a beach chair position with a C-arm fluoroscope for intraoperative imaging.

Anatomical surgical approach:  A minimally invasive anterolateral approach was utilized. A small incision was made over the deltoid muscle, and subdeltoid dissection was performed to expose the proximal humerus. The fracture site was visualized, and reduction was achieved using percutaneous techniques.

Proximal screws were inserted into the head of the humerus (Fila A) and secured with Kirschner wires to maintain temporary stability. Once the plate and proximal screws were confirmed to be in adequate position via fluoroscopy, the medial displacement of the diaphysis was reduced using a cortical screw. Final fixation was completed by inserting diaphyseal screws.

Postoperative protocol:   Postoperatively, the patient was advised to wear a shoulder immobilizer during the day for 4 weeks. Passive range of motion exercises were initiated immediately, progressing to active-assisted exercises at 6 weeks post-surgery. Full weight-bearing and unrestricted activities were allowed by 12 weeks postoperatively.

Follow up:   Not specified

Orthopaedic implants used:   Proximal humeral locking plate, Kirschner wires, cortical screw