Reverse shoulder arthroplasty for two-parts proximal humerus fractures with “Shish-kebab” technique

Reverse shoulder arthroplasty (RSA) is an established surgical option for the treatment of displaced three and four-parts proximal humerus fractures, with a well described surgical technique and better reported outcomes if compared to open reduction and internal fixation. On the contrary, there is a paucity of data about the use of RSA in displaced two-parts surgical neck fractures. RSA implantation, in these cases, is technically challenging because of the frequent need for tuberosity osteotomy, a more difficult evaluation of the stem height, and a higher risk of tuberosities nonunion or malunion, with worse clinical outcomes. In this article, we describe a surgical technique to implant the humeral stem in case of two-parts surgical neck fractures, avoiding tuberosity osteotomy and decreasing the risk of tuberosities nonunion.