PMC3109768_01
Original injury
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F0002
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].
Immediate postoperative fixation
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F0003
In view of his age, he underwent open reduction and internal fixation of the fracture with a proximal humeral locking plate [Figure 3].
Advanced collapse at 6 weeks. The protruding screw was promptly removed
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F0004
This lead to protrusion of one of the screws into the articular region 6 weeks postoperatively [Figure 4], which was promptly removed.
Malunion at 9 months
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F0005
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].
Excised bony spur
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F0006
This was removed using a fine saw [Figure 6].
HemiCAP inserted
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F0007
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.
Check radiograph postoperatively
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F0008
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].