Arthroscopically Assisted Surgical Decompression and Fibular Strut Grafting for Proximal Humerus Avascular Necrosis: Surgical Technique

Avascular necrosis is a relatively common entity that affects the proximal humerus and can lead to substantial morbidity. It often occurs in younger patients for whom the traditional treatment of shoulder arthroplasty is not optimal. Fibular strut grafting to prevent humeral head collapse has been described as a viable treatment option. However, it is technically challenging to direct the fibular strut graft into the center of the bony infarct, where it will be most effective. This paper describes a technique of arthroscopically assisted fibular strut grafting for avascular necrosis of the humerus. This is a minimally invasive technique with low morbidity and an accurate way of placing the graft into the infarcted segment.