Table 1.

Stepwise Technique Overview

Preoperative

3D CT reconstruction with humeral head subtraction

Medical stabilization/optimization

OR setup

Lateral decubitus position

Acquisition of fluoroscopic image before preparation and draping

Intraoperative assessment

Establishment of standard posterior viewing and anterior working portals

Diagnostic arthroscopy completion

Establishment of accessory posteroinferior (7-o'clock) portal and placement of cannula

Proper trajectory ensured using spinal needle

Fracture hematoma debridement and fracture mobilization

Provisional fracture reduction using probe

Guidewire placement through fragment into fracture site

Additional reduction using guidewire as joystick

Passage of guidewire into far cortex

Second guidewire placement outside of cannula for rotational stability

Cannulated screw placement

Assessment of fracture reduction

Postoperative management

Non–weight bearing

Sling use for comfort initially; progression to active ROM as tolerated

Resistance exercises at 6 wk postoperatively

CT, computed tomography; OR, operating room; ROM, range of motion; 3D, 3-dimensional.