الفهرس 
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Abstract
SUMMARY
The proximal humerus includes the articular surface, greater tuberosity, lesser tuberosity, and the humeral shaft. Fractures of the proximal humerus account for approximately 5 % of all fractures of the human body.
The most common mechanism of injury for a proximal humerus fracture is a fall on an outstretched arm.The most common patient with a proximal humerus fracture is an elderly patient who has sustained a ground level fall. Younger patients sustain this fracture after higher energy injuries.
Ecchymosis and swelling of the shoulder are common physical exam findings. Radiographic evaluation is typically sufficient for assessment and classification of a proximal humerus fracture.Computed tomography (CT) images can be a useful tool in evaluation and classification of proximal humerus fractures.
The majority of proximal humerus fractures are stable fracture patterns and very amenable to nonoperativetreatment. Fractures with minimal displacement regardless of the number of fracture lines, can be treated with closed reduction and early mobilization.
Open reduction and internal fixation has an extensive surgical exposure and risks damage to the vascular supply of the fragments. Fixed angle locking plates enable fixation of many complex fractures. Locked intramedullary nails can be inserted using a minimally invasive technique, but risk proximal impingement.
Closed reduction and percutaneous pinning has a low risk of neurovascular complications or interference with glenohumeral joint motion.
External fixation achieves a satisfactory fracture reduction and stability, safer healing and a superior functional result, compared to conservative treatments.
A cross-sectional prospective study conducted a study on patients with displaced humerus fracture. Managed in the study hospitals and are eligible for fixation external fixator. The study was carried out on 20 patients attending to Orthopedic Surgery Department, Faculty of Medicine, and Beni-Suef University after approved by local committee and an informed consent.
Thestudy includes 20 patients, 8patients (4%) were female and 12 patients (60%) were males, 40% of patients their fixation were in right side. Mean of age were 33.7with range from 8to 80years.In our study 4 patients (20%) were having diabetes mellitus.
The study showed that 19 patients (95%) their type of fracture were (11-A2 & 11-A3).one only (5%) were having associated Fractures.
In the study3 patients were having delayed union, 6 patients (30%) were having Pin tract infection. Mean of pain were 28.25 with range from 5 to 35, Mean of Motion were 20.05 with range from 12 to 25, Mean of Function were 27.5 with range from 22 to 30 and Mean of Reconstruction of anatomy were 8.6 with range from 4 to 10.
In the study there 10 patients (50%) were excellent Neer’s scoring, 2 patients (10%) were good Neer’s scoring, 5 patients (25%) were fair Neer’s scoring and 3 patients (15%) were poor Neer’s scoring. Mean of Neer’s scoring were 84.4 with range from 50 to 100.
Osteosynthesis with external fixator can be considered as a valid treatment for proximal humeral fractures to stabilize the fracture, preserve the humeral head vascularization and early mobilize the shoulder. In elderly patients, an early recovery of motion allows a faster functional recovery of the limb and therefore a faster return to everyday life.