Rheumatoid arthritis affects women more frequently, aged 40 to 70, three times more frequently than men. Bone changes occurring in people with rheumatoid arthritis increase the incidence of fractures in these patients [1]. In the complex fractures of the proximal 3 of the humerus, the treatment of choice is represented by open reduction and osteosynthesis. This method can also be applied minivasively, known as minimally invasive plate osteosynthesis (MIPO)[2,3]. [...]

Proximal humerus fractures result from indirect trauma, are associated with osteoporosis, and are classified into: humeral head fractures, anatomical cervical fractures, trochiter, trochin, surgical neck, or proximal diaphysis. Types of fracture and displacement are determined by the position of the humerus at the time of trauma, bone quality and the direction of muscle forces on fractured fragments[1,2].
Fractures with two, three or four shifted parts require surgical treatment. The dislocation fractures, except for the simple trohiter fractures, should be analyzed by the orthopedic surgeon, the reduction of the dislocation will precede the treatment of the fracture. It should be emphasized that powerful damping maneuvers can move fractured fragments, so it will be preferable to reduce it under radiological control[14]. [...]