Some surgeons achieve press fit of the humeral stem by wedging the distal tip of the stem in diaphyseal bone as shown below. As also shown below, this can result in a too high position of the humeral component because it could not be fully inserted. A possible consequence is eccentric loading of the glenoid and glenoid component loosening as shown here.
Our approach is to achieve a snug fit of the humeral component using impaction grafting as shown below. This enables fine tuning of the humeral component position and minimizes the risk of fracture at the tip of the humeral stem. Some of the details of the technique are shown here.
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