Fractures of the proximal humerus are common, especially in elderly individuals, and are usually classified according to Neer into fractures having one, two, three, or four parts with or without an associated dislocation or an injury splitting the humeral head. This article is intended to assist the surgeon in selecting and using techniques for internal fixation of these fractures. The use of o...

Humeral non unions are often painful and unstable Good surgical management is sometimes very difficult. Fixation with plates and screws and bone grafting may fail. The outcome of revision operation may be adversely affected by restricted movement of elbow. In most cases, the patient has been several times operated with resultant scarring and cicatrisation of the surrounding soft tissues. This r...

Between 1993 and 2000 we treated 14 patients with nonunion of fractures of the distal humerus; 11 had already had previous fixation which had failed. The mean time to surgery was 21 months after injury. All the fractures were very low which made it difficult to obtain a firm hold of the small distal fragment. The problem of fixation was addressed by inserting a Coventry infant hip screw into th...