Case 1, presented by David M. Dines, MD, Attending Orthopaedic Surgeon at HSS, Samuel A. Taylor, MD, Orthopaedic Surgery Resident at HSS, Joshua S. Dines, MD, Assistant Attending Orthopaedic Surgeon at HSS and Dean G. Lorich, MD, Associate Director of Orthopaedic Trauma Service describes a 70-year-old woman who presented to HSS for management of a left proximal humeral fracture. Physical examination revealed significant resolving swelling and ecchymosis about the left shoulder as well as dependent edema in the left upper extremity. Range of motion was full in the ipsilateral elbow and wrist, but pain limited motion in the shoulder. The patient was neurovascular intact distally. Axillary nerve function was preserved. Examination of the contralateral shoulder was significant for severely limited forward flexion and external rotation, as well as harmonic crepitus. The patient was treated at two weeks following her trauma with an early primary reverse total shoulder arthroplasty and tuberosity repair (Figures 3 and 4). She did well postoperatively, returning to her previous level of activity, and was so happy with her results that she subsequently underwent a standard total shoulder replacement (TSR) on the contralateral side with similarly pain-free function at early follow-up.
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