Multilocking Nailing Procedure for Proximal Humerus Fracture

Preoperative Assessment and Planning

• CT scan is the preferred imaging modality for detailed evaluation of fracture pattern, as it provides superior delineation of fracture lines compared to plain radiographs, according to the American College of Radiology 1, 2
• Three-dimensional volume-rendered CT images help better characterize fracture patterns and humeral neck angulation, which can affect functional outcomes, as recommended by the American College of Radiology 2
• Consider associated rotator cuff tears, which occur in up to 40% of humeral head fractures, as noted by the American College of Radiology 1

Step-by-Step Procedure

• Perform sequential reaming over the guide wire, as described in the Journal of the American College of Radiology 1

Role of CT Imaging in Initial Assessment of Proximal Humerus Fractures

Diagnostic Imaging

• In patients with proximal humerus fractures, obtaining a computed tomography (CT) scan immediately after standard radiographs enhances fracture characterization and changes clinical management in up to 41 % of cases by revealing fracture complexity not apparent on plain films. 3