Abstract

• Proximal humerus frartures occur most commonly in elderly people, especially with osteoporotic bone. But recently these fractures are also common in younger people due to the increased incidence of trafnc accidents or sports injuries.
  It is reported that displacement of major fracture fragments can be observed in about 20 percents of proximal humerus fractures and they need some form of surgical treatment.
  But when there is a sevfre comminution in the area of surgical neck which precludes anatomical reduction, it is almost impossible to obtain rigid fixation and to start an early motion.
  We reported ten cases of unstable proximal humerus fractures with severe comminution of surgical neck which preclude anatomical reduction and stable rxation and require impaction of the shaft fragment into the head and fixation with multiple pins and tension band wiring.
  After an arevage follow-up period of 30 months, we obtained the following results:
  1. Nine cases out of 10 showed satisfactory results, excellent in 2 cases and good in 7 cases. But there was 1 case in poor.
  2. In complications, 2 cases showed transient postoperative subluxation and 3 case showed moderate joint stiffness. But there was no avascular necrosis of humeral head.
• Key words: Proximal humelts fractures, Severe surgical neck comminution, Impaction Tension-band wiring technique

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