ORTHOPEDICS | Healio.com/Orthopedics n Feature Article abstract Full article available online at Healio.com/Orthopedics. Search: 20121120-17 Studies have reported conflicting results regarding external fixation for displaced proxi- mal humeral fractures. Compared with open reduction and internal fixation, external fix- ation for displaced proximal humeral fractures avoids dissection and soft tissue stripping and leads to higher union rates, a lower incidence of avascular necrosis, less scaring of the scapulohumeral interface, and faster rehabilitation. Some authors have reported good or excellent results and minimum complications compared with open reduction and internal fixation; however, others have reported that external fixation does not en- sure acceptable reduction and fracture stability, especially in patients with osteoporosis. This article describes 18 patients with displaced 2-part fractures of the surgical neck of the humerus treated with closed reduction and external fixation using the Tension Guide Fixator (Gexfix SA, Carouge, Switzerland) external fixation system between 2010 and 2011. The patients included 14 women and 4 men with a mean age of 39 years. Mean follow-up was 18 months (range, 15-24 months). Fracture union; function us- ing the Constant score, University of California Los Angeles score, Oxford score, and Quick Disabilities of the Arm, Shoulder and Hand shoulder score; and complications were evaluated. All patients experienced fracture union at a mean of 11 weeks (range, 9-13 weeks). The Tension Guide Fixator was removed without anesthesia at the outpa- tient clinic at a mean of 6 weeks (range, 4-8 weeks) with no loss of reduction or sec- ondary displacement after removal. At 1-year follow-up, mean Constant and University of California Los Angeles scores were excellent, mean Oxford score showed satisfac- tory joint function, and mean Quick Disabilities of the Arm, Shoulder and Hand score showed minimal pain with no disability. Drs Benetos, Karampinas, Romoudis, Pneumaticos, and Vlamis are from the Third Department of Orthopaedics, and Dr Mavrogenis is from the First Department of Orthopaedics, Athens University Medical School, KAT Hospital, Athens, Greece. Drs Benetos, Karampinas, Mavrogenis, Romoudis, Pneumaticos, and Vlamis have no relevant finan- cial relationships to disclose. Correspondence should be addressed to: Ioannis S. Benetos, MD, 11 Georgiou Stavrou Str, Filothei 152-37, Athens, Greece (ioannisbenetos@yahoo.gr). doi: 10.3928/01477447-20121120-17 External Fixation for Displaced 2-part Proximal Humeral Fractures IOANNIS S. BENETOS, MD; PANAYIOTIS K. KARAMPINAS, MD; ANDREAS F. MAVROGENIS, MD; PAVLOS ROMOUDIS, MD; SPIROS G. PNEUMATICOS, MD; JOHN VLAMIS, MD Figure: Fluoroscopic images showing fracture reduc- tion and introduction of 2 Kirschner wires from a su- perior entry point into the medullary canal (A) and in- sertion of the 2 half-pins in the humeral diaphysis (B). A B e1732