TechniqueFailed Proximal Humerus Osteosynthesis Using Intramedullary Fibular Strut Allograft Conversion to Reverse Shoulder ArthroplastyManzi, Joseph E. BS*; Ruzbarsky, Joseph J. MD†; Rauck, Ryan C. MD†; Gulotta, Lawrence V. MD†; Dines, Joshua S. MD†; Dines, David M. MD†Author Information *Weill Cornell School of Medicine †Hospital for Special Surgery, New York, NY Conflicts of Interest and Source of Funding: The authors report no conflicts of interest and no source of funding. Address correspondence and reprint requests to Joseph E. Manzi, BS, Weill Cornell School of Medicine, 407 E 61st St, New York, NY 10065. E-mail: email@example.com. Techniques in Hand & Upper Extremity Surgery: March 2020 - Volume 24 - Issue 1 - p 7-12 doi: 10.1097/BTH.0000000000000260 Buy Metrics Abstract Comminuted proximal humerus fractures are more frequently being treated utilizing an intramedullary fibular strut allograft to assist with open reduction internal fixation. Although this technique has led to improved outcomes, avascular necrosis, rotator cuff failure, and/or prominent hardware may still occur necessitating conversion to reverse shoulder arthroplasty. The presence of an intramedullary strut allograft makes this conversion technically demanding and creates certain potential complications unique to this group. This manuscript details the conversion of a proximal humerus open reduction internal fixation with a fibular strut allograft to reverse shoulder arthroplasty including presurgical workup, surgical techniques, and pitfalls for undertaking this increasingly common scenario. Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.