Proximal humeral allograft in a trauma setting

Proximal humeral allografts are usually reserved for reconstruction of the shoulder in a neoplastic setting. To our knowledge it has never been described for use in a trauma setting. In this case report, we present a 30-year-old man involved in a motor vehicle accident (MVA) in 2007. He is right-hand dominant and employed as a driver. He presented initially to a peripheral hospital, and he sustained what seems to be a right floating shoulder injury with clavicle, scapula and proximal humeral fractures. He was operated there and underwent excision of the proximal humerus. Subsequently he presented to us and a staged procedure was performed. Initially, the clavicle was plated and, six weeks later, he underwent reconstruction with a proximal humeral allograft. All rotator cuff muscles were re-attached and the allograft was secured with cement and an intramedullary nail. We present his pre-op and post-op pictures as well as the function achieved. We also present a brief review of the literature.