The medullary canal of the humerus varies widely in its shape within the same patient and among patients. This makes fixing a prosthesis with a press fit difficult because of the challenge in matching the shape of the implant to the inner cortex of the humerus as shown in these figures copyrighted by Steve Lippitt.
For this reason we use impaction grafting using bone harvested from the resected humeral head to fit the bone to the prosthesis.
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