Insert stay sutures through the supraspinatus, and if necessary, the infraspinatus tendon.
Cleaning the fracture bed
Clean the fracture bed and remove any hematoma. Prepare the margin of the fracture by removing or reflecting the periosteum, 2 or 3 mm back from the fracture line.
Reduce the greater tuberosity properly by pulling on the stay suture(s). Be careful not to fragment the tuberosity with bone holding clamps.
Once the fragment is at the correct level, rotate the arm so that the fragment can fit anatomically into the bony defect.
Temporarily secure the reduction with 1 or 2 K-wires.