case_images: PMC3109768_01
case_images: Original injury
case_images: IJSS-5-17-g002.jpg
case_images: PMC3109768_01_IJSS-5-17-g002.jpg
case_images: F0002
case_images: An active 46-year-old right hand-dominant nonsmoking healthy male chef presented with a four-part proximal humeral fracture following a motorcycling accident [Figure 2].
case_images: Immediate postoperative fixation
case_images: IJSS-5-17-g003.jpg
case_images: PMC3109768_01_IJSS-5-17-g003.jpg
case_images: F0003
case_images: In view of his age, he underwent open reduction and internal fixation of the fracture with a proximal humeral locking plate [Figure 3].
case_images: Advanced collapse at 6 weeks. The protruding screw was promptly removed
case_images: IJSS-5-17-g004.jpg
case_images: PMC3109768_01_IJSS-5-17-g004.jpg
case_images: F0004
case_images: This lead to protrusion of one of the screws into the articular region 6 weeks postoperatively [Figure 4], which was promptly removed.
case_images: Malunion at 9 months
case_images: IJSS-5-17-g005.jpg
case_images: PMC3109768_01_IJSS-5-17-g005.jpg
case_images: F0005
case_images: Radiographs at 9 months showed malunion of the fracture, with a bony spur present at the superior part of the head where the collapse segment went on to malunion [Figure 5].
case_images: Excised bony spur
case_images: IJSS-5-17-g006.jpg
case_images: PMC3109768_01_IJSS-5-17-g006.jpg
case_images: F0006
case_images: This was removed using a fine saw [Figure 6].
case_images: HemiCAP inserted
case_images: IJSS-5-17-g007.jpg
case_images: PMC3109768_01_IJSS-5-17-g007.jpg
case_images: F0007
case_images: The appropriate articular component was then placed in its post [Figure 7], restoring a smooth humeral surface at the area where the bony spur was previously present.
case_images: Check radiograph postoperatively
case_images: IJSS-5-17-g008.jpg
case_images: PMC3109768_01_IJSS-5-17-g008.jpg
case_images: F0008
case_images: Repeat radiographic assessment showed no loosening or displacement of the prosthesis, no new bony outgrowth and no changes to the opposing glenoid articular surface [Figure 8].