case_images: PMC9974937_01
case_images: Preoperative X-ray of the patient's right shoulder depicting the anteromedial defect over the head of the humerus. (A) Anteroposterior view. (B) Axillary view.
case_images: cureus-0015-00000034356-i01.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i01.jpg
case_images: FIG1
case_images: On the preoperative AP and axillary X-rays of the right shoulder, a defect was seen on the anteromedial aspect of the humerus (Figure 1) and the CT scan showed the posterior shoulder fracture dislocation.
case_images: CT scan depicts the extent of the defect.
case_images: cureus-0015-00000034356-i02.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i02.jpg
case_images: FIG2
case_images: It also helped in quantifying the bone defect (Figure 2) showing impaction fracture involving >40% of the humeral head.
case_images: Patient positioning and surgical site preparation.
case_images: cureus-0015-00000034356-i03.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i03.jpg
case_images: FIG3
case_images: Scrubbing, painting, draping, and marking of the surgical site incision were done (Figure 3) from the distal to the lateral edge of the clavicle and just lateral to the coracoid process.
case_images: Sutures through the subscapularis tendon.
case_images: cureus-0015-00000034356-i04.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i04.jpg
case_images: FIG4
case_images: After exposure, a frayed and thinned-out tendon of the long head of the biceps was noted, for which a tenotomy was done (Figure 4).
case_images: Osteotomized lesser tuberosity bone chunk.
case_images: cureus-0015-00000034356-i05.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i05.jpg
case_images: FIG5
case_images: Lesser tuberosity bone chunk fixed with a cannulated cancellous screw.
case_images: cureus-0015-00000034356-i06.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i06.jpg
case_images: FIG6
case_images: A measured partially threaded, cannulated screw with a washer was placed over the guide wire to achieve compression of the fragment of lesser tuberosity onto the humeral defect (Figure 6).
case_images: Postoperative X-ray of the patient with the bone chunk over the defect and implant in situ. (A) Anteroposterior view. (B) Lateral view of the proximal humerus.
case_images: cureus-0015-00000034356-i07.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i07.jpg
case_images: FIG7
case_images: Figure 7 showed the immediate postoperative X-ray where the defect over the anteromedial aspect of the humerus is covered with the lesser tuberosity bone chunk and with implants in situ.
case_images: Follow-up after six months with (A) forward flexion of 130 degrees, (B) external rotation of 30 degrees; and (C) internal rotation till L4.
case_images: cureus-0015-00000034356-i08.jpg
case_images: PMC9974937_01_cureus-0015-00000034356-i08.jpg
case_images: FIG8
case_images: The patient had no symptoms and had a pain-free, stable shoulder joint at the time of the last checkup (Figure 8).