The surgeon examines the X-Ray & the physical condition of the patient & continuously monitors the vitals. After establishing the fitness of the patient for surgery, the surgeon counsels the patient & relatives for expected outcome of the surgery. In case the patient is unfit, the doctor may decide to use an External Fixation system for temporary fixation.
The Surgeon administers some antibiotics before the surgery to ensure a better healing & reduces the chances of post-operative infections.
In these kinds of fractures, generally deltopectoral or transdeltoid approach is used. The surgeon first reduces the humerus fracture & bring bone in the normal shape to ensure proper healing. The reduction is generally achieved using K-wires.
After the fracture is reduced the plate is temporarily fixes the plate 2 to 4 mm posterior to the bicipital groove & 5 to 7 mm distal to the top of the greater tubercule using 3.5mm Cortex Screw. Then the surgeon proceeds with rest of screws & locking of the plate