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Related Concept Videos

Bones of the Upper Limb: Humerus01:19

Bones of the Upper Limb: Humerus

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The upper limb consists of the arm, forearm, wrist, and hand bones. The humerus is the single bone of the upper arm region. Proximally, it has a large, spherical, smooth head that articulates with the glenoid cavity of the scapula to form the glenohumeral or shoulder joint. The margin of the head is the anatomical neck, a residual epiphyseal plate. Laterally it extends to form bony projections called the greater tubercle and the lesser tubercle. Next to the tubercles is the surgical neck, a...
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Related Experiment Video

Updated: Sep 13, 2025

Reverse Total Shoulder Arthroplasty
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Reverse Total Shoulder Arthroplasty

Published on: July 5, 2011

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Reverse Total Shoulder Arthroplasty for Proximal Humerus Nonunion.

James Tyler Frix1, Maria Kammire1, Nainisha Chintalapudi1

  • 1Atrium Health Carolinas Medical Center, 2001 Vail Ave, Charlotte, NC 28207, USA.

Journal of Clinical Medicine
|July 29, 2025
PubMed
Summary
This summary is machine-generated.

Preserving and repairing tuberosities during reverse total shoulder arthroplasty (RTSA) for proximal humerus nonunion can improve stability and function in elderly patients. This technique enhances outcomes by reducing dislocation risk and aiding recovery.

Keywords:
RTSAfracturegreater tuberositylesser tuberositynonunionproximal humerus fracturereverse total shoulder arthroplastyshoulder arthroplastytuberositytuberosity repair

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Area of Science:

  • Orthopedic Surgery
  • Arthroplasty
  • Trauma Surgery

Background:

  • Surgical neck nonunions of the proximal humerus are challenging, particularly in elderly patients with glenohumeral arthritis.
  • Resection of tuberosities during reverse total shoulder arthroplasty (RTSA) can compromise joint stability and function.
  • A novel RTSA technique preserving and repairing tuberosities is presented to address these challenges.

Observation:

  • A 74-year-old female with glenohumeral arthritis and proximal humerus nonunion underwent RTSA.
  • The technique involved mobilizing the nonunion, performing tuberosity osteotomies, and securing the tuberosities after implant placement.
  • A cerclage suture was used to reinforce the repair and prevent posterior gapping.

Findings:

  • The patient achieved pre-injury functional levels, with pain-free active forward elevation to 110 degrees.
  • Radiographic evidence showed maintained tuberosity reduction and healing.
  • No signs of postoperative instability were observed.

Implications:

  • Tuberosity preservation and repair in RTSA for proximal humerus nonunion may decrease dislocation risk.
  • This approach can potentially optimize functional recovery in elderly, low-demand patients.
  • The described technique offers a reproducible method for enhancing construct stability in complex shoulder reconstructions.