The simple radiographic examination is a useful tool in the diagnosis of the proximal humerus fractures, providing important information regarding the extent of the fracture, the number of fragments, their possible decomposition and the articular surface’s involvement.
Today, the trauma series remains the gold standard as a first-level examination when there is shoulder trauma (Ney et al., IEEE Comput Graph Appl 10:24–32, 1990). It includes a true anteroposterior radiograph on the scapula plane which provides us with a real anteroposterior image of the glenohumeral joint, a lateral projection onto the scapula plane or a Y-projection of the scapula and an axial projection. The goal is to carry out an examination that altogether describes the fracture picture through the three floors of the space at best in order to obtain a description that is the most realistic and complete.
It is not always possible with simple radiographic examination to come to a correct classification of the fracture in order to plan the most suitable therapy. In recent years, thanks also to the technological development of diagnostic equipment, it is more and more frequent to resort to computed tomography (CT) for the assessment of proximal humerus fractures, especially when we decide to undertake the surgical treatment in such a way to carry out a pre-planning operation as accurately as possible and to have an idea as realistic as possible about what the intraoperative situation to be faced will be.
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