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Reduction and preliminary fixation

Correct the valgus impaction by elevating the lateral aspect of the humeral head

Reduction of the humeral head

The varus displaced humeral head has to be lifted first. Due to the degree of impaction the force applied to reduce the humeral head might vary.

Use a periosteal elevator in combination with ligamentotaxis to reduce the humeral head.

Additional valgus force could be helpful. This can be achieved by pressing on the proximal humerus from lateral.

Perform the reduction under image intensifier control.