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Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series



To report the functional and radiological results of unusual comminuted fractures of the proximal humerus, treated with ‘closed reduction and external fixation’ (CREF) using hybrid-type unilateral external fixators (EFs).

Patients and methods

Between January 2012 and June 2013, eight patients (mean age 62.6; range 48–84 years) with comminuted proximal humeral fractures extending to the humeral head and one-third proximal diaphysis were treated with CREF using hybrid-type EFs. Functional results were evaluated in terms of shoulder ranges of movement, Constant, DASH, and VAS scores, and radiological results were evaluated using antero-posterior and lateral radiograms of the treated humerus.


The mean follow-up was 16.6 (range 12–28) months. The mean fixator time was 84 (range 63–118) days. The mean range of forward flexion, internal rotation, external rotation, and abduction were 145°, 61.2°, 65°, and 115°, respectively. The mean Constant, DASH, and VAS scores were 79.8, 10, and 1.75, respectively. Seven of the eight patients (87.5 %) healed radiologically. Two complications were observed in two patients: non-union and superficial pin site infection.


In the treatment of unusual, comminuted proximal diaphyseal humeral fractures, CREF using a hybrid-type EF is a minimally invasive, advantageous procedure with acceptable rates of healing, low risk of surgical site infection, and early range of motion.

Level of evidence

Level IV, case series.

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Correspondence to Fatih Yıldız.

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Uzer, G., Yıldız, F., Elmadağ, M. et al. Treatment of unusual proximal humeral fractures using unilateral external fixator: a case series. Eur J Orthop Surg Traumatol 25, 683–687 (2015).

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  • Humerus
  • Fracture
  • Comminuted
  • Closed reduction
  • External fixator