Related Experiment Video
Updated: Aug 23, 2026
Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Avoiding Iatrogenic Axillary Artery Injury in Reverse Total Shoulder for Fracture: The Use of a Separate Axillary
Patrick M Wise1, Douglas R Haase
1Department of Orthopedic Surgery, University of Missouri Health, Columbia, Missouri.
Case:
A 71-year-old woman sustained a left proximal humerus fracture dislocation. Imaging demonstrated displacement of the humeral head medial to the axillary artery without initial injury. To avoid iatrogenic injury, a separate medial axillary incision was successfully used to remove the humeral head and then reverse total shoulder arthroplasty was performed through a deltopectoral approach. At 1 year, the patient had excellent range of motion and PROMIS Physical Function CAT (v2.0) score was 46.2.
Conclusions:
A separate medial axillary approach can be used to safely remove anterior/inferior humeral head fragments and avoid neurovascular injury in reverse total shoulder arthroplasty for proximal humerus fracture dislocations.
