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Treatment of humeral four part fracture with anatomical neck fracture (H. F. A.) has many problems; avascular necrosis, functional disorder, continuing shoulder pain and so on. Neer prefers prosthetic replacement to osteosynthesis. We treated one case with Jones operation and the other with osteosynthesis.The first case was a 50-year-old woman and X-ray finding was H. F. A. with dislocation. She received Jones operation two times and results were satisfactory one and half year after the operation (shoulder abduction, 120°; flexion, 160°).The second case was a 82-year-old woman and the diagnosis was H. F. A. with displacement. Osteosynthesis was done 3 weeks after the trauma. There was no avascular necrosis of the humeral head and results were good a year after the operation (shoulder abduction, 90°; flexion, 130°).

Two cases of operative treatment of proximal humeral four part fracture.