[Minimal osteosynthesis of fractures of the head of the humerus. Indications, technic, results].

Between 1983 and 1987 minimal osteosynthesis for proximal humeral fractures was performed in 30 patients, 23 women and 7 men, with an average age of 58.5 years. According to the Neer classification there were 10 two-part, 9 three-part and 11 four-part fractures. Internal fixation was achieved with Kirschner wire (n = 9), cancellous screws (n = 4) or tension band (n = 17). The technique of internal fixation with Kirschner wire and lateral tension band is described. Follow-up examination was possible in 26 patients after 14 months. The functional results were excellent in 6 cases, good in 4, satisfactory in 14, and poor in 2 cases. According to Neer's protocol the overall results were excellent in 5 cases, satisfactory in 7 cases, unsatisfactory in 7 cases and poor in 7 cases. The treatment of displaced proximal humeral fractures, especially in elderly patients, is still an unsolved problem. As functional results were satisfactory or even better in three-quarters of the four-part fractures treated, we conclude that internal fixation using Kirschner wire and tension band can be recommended.