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Abstract
Displaced unstable fractures of the proximal humerus may result in pain as well as in delay of union. both contributing to prolonged immobilization and unsatisfactory results. Therfore. we must consider operative treatment for these fracture. When surgery is attempted. however. major technical problems may be encountered precluding stable fixation allowing early motion. Authors have attempted various methods of fixation for displaced proximal humeral fractures and compared the pitfalls and complications related to the each methods of fixation. The following results were obtained.
1. According to Neer classification, three-part fracture (45.8%) was the commonest type.
2. Two-part fractures were treated mainly by closed method and fractures of three-part or more. by open reduction.
3. Postoperative immobilization period was shortest (mean: 9 days) in the group of rigid fixation with a plate and screws.
4. Overall clinical result according to Neer crileria as excellent or good in 68.5% (24 of 35 cases) ;60%(6 of 10 cases) in K-wlre fixation and 50%(2 of 4 cases) in long staple fixation after closed reduction, and 55.6% (4 of 7 cases) in K-wlre & screw fixation and 85.7%(12 of 14 cases) in a plate & screw fixation after open reduction.
5. The commonest complication was joint stiffness (6 cases) and 4 cases of these were in the group of closed methods Four cases of malunion were all 3-part fractures treated with K-wire fixation after Closed reduction, and redisplacement developed in 4 cases in closed reduction & K-wire or long staple fixation. And 2 cases of nonunion developed all after long staple fixation.
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