Hi - Need help with a shoulder surgery, excision of a greater tuberosity fragment for a periprosthetic fracture. Following her incisional scar I made an incision over the anterior aspect of her left shoulder performing a standard deltopectoral approach to the shoulder. I released the subacromial and subdeltoid spaces and brought the patient's arm into slight abduction and internal rotation. I was able to identify the greater tuberosity fragment which was posterior row superior. It was scarred in. She had limited external rotation. I proceeded to use a ronguer to excise this fragment. Intraoperative fluoroscopy was utilized to confirm adequate excision. There is still tiny fragments scarred into the soft tissue but the bulk of it was gone after I was done. She demonstrated significant improvement in her external rotation. Her shoulder was stable. The lesser tuberosity and subscapularis appear to be healed. I proceeded to thoroughly irrigate the patient's shoulder using Irricept followed by copious amounts of sterile saline. Hemostasis was achieved using electrocautery. Layered closure of the patient's incision was performed using 0 Vicryl, 3-0 Vicryl, and 3-0 Prolene. Sterile dressings were applied using Steri-Strips, 4 x 4 gauze and Tegaderm. She was placed in a sling, she was awoken, extubated, transferred to her bed, and wheeled to recovery in stable condition. Thank you!