The use of computed tomography with two- and three-dimensional reconstructions in the diagnosis of three- and four-part fractures of the proximal humerus.

Spiral computed tomography (CT) with three-dimensional and multiplanar reconstructions was used to assist in the diagnosis of three- and four-part fractures of the proximal humerus in 10 patients. CT added important information to that obtained by conventional radiography in four patients. It verified impaction of the capital fragment in two patients. In a patient with a four-part fracture metaphyseal attachment to the head fragment was demonstrated and in a patient with a three-part anterior fracture dislocation an osseous Bankart lesion was shown. In all patients CT clearly visualized the degree of displacement of tuberosity fragments which can be valuable when planning open reduction and internal fixation.