Fig. 4From: Reconstruction with a double-constrained implant design after complex shoulder extra-articular resectionSurgical steps for implant fixation. Superior images demonstrating the fixation of the glenoid component with two sets of perpendicular screws (arrows) and the placement of the proximal end of the dumbbell connector. Inferior images showing the humeral component fixation, final connection of the dumbbell component, and closure with the use of a synthetic mesh. Green arrow, 3 planar screws through the glenoid component. Blue arrows, 2 perpendicular screws for enhanced fixation of the glenoid component to the native scapulaBack to article page