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Three Part Fracture Dislocation


- See: Three Part Fracture

- Discussion:
    - includes large proximal fragment created by frx of surgical neck of humerus;
    - some capsular tissue is almost always retained on large head fragment ensuring its viability;
    - if head fragment is displaced anteriorly, greater tuberosity is usually frxed, whereas lesser tuberosity is retained;
    - frxed tuberosity segment is always displaced in a direction opposite to the dislocation;
    - in posterior fracture dislocation, greater tuberosity is usually retained, whereas the lesser tuberosity is avulsed;

- Treatment:

    - closed reduction w/ GEA to restore prox frag to anatomic position;
    - if gross instability of frx remains after closed reduction of dislocation, then ORIF is required;
    - if reduction of the proximal fragment is blocked by soft tissue interposition, then open reduction is manditory