It is the surgeons preference whether to use 3.5 mm cannulated lag screws or small fragment screws. enlarge

It is the surgeons preference whether to use 3.5 mm cannulated lag screws (as illustrated) or small fragment screws.

Note: Washers might be advisable with osteoporosis or fragmentations. Generally, they are not preferable as they make the screw heads more prominent and may result in shoulder impingement.


If the greater tuberosity fragment is large, two screws may be used for better fixation. enlarge

Large fragments
If the greater tuberosity fragment is large, two screws may be used for better fixation.

Note: make sure to avoid the axillary nerve by placing the second screw rather proximal.


Once osteosynthesis is completed remove all K-wires. Check fixation by image intensification. enlarge

Completed osteosynthesis

Once osteosynthesis is completed remove all K-wires.
Check fixation by image intensification.