This patient presented with a chronic anterior dislocation of the humeral head after a proximal humerus fracture, the humeral head was malunited in the subscapularis recess. Osteotomy of the humeral head was required to remove the bone from the anterior glenoid. The fracture was addressed with hemiarthroplasty and repair of the tuberosities. The use of a stem that provides a "window" for proximal bone grafting, the removal of the cement circumferentially from the proximal stem during implantation, and the stable suture repair of the tuberosities with Fiberwire provided a good outcome with union of the tuberosities. The anterior inferior subluxation of the humeral head persisted for 6 months but eventually it was resolved. Contrary to the belief that this is the result of a "fracture hematoma" it seems that this finding is associated with muscle atony or contusion of the rotator cuff or axillary nerve neuropraxia. X-rays are shown below.
