[Ortho] протез или синтез?

[Roger Sohn]

It looks like it needs a hemi. The head is likely dead. I think a ct would help delineate the amount of humeral head metaphyseal piece is intact, but even if there is some metaphyseal bone, with the prolonged dislocation, I think it's doomed for avn.

As for the radial nerve, is the tricep working? What are the recent emg's like?  Assuming the nerve damage is permanent, he would likely need nerve or tendon transfers after the shoulder heals and he has no documented return of function. Do you have someone that can do a posterior branch axillary to radial nerve transfer?

Good luck with this. It's a tough case in such a young person.

Roger Sohn