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- Loss of medial calcar support and severe comminution A metaphyseal or intramedullary device may be necessary to restore stability of the medial calcar
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- Initial displacement of the greater tuberosity Sutures in the rotator cuff are recommended for tuberosity fixation but do not require supplementation of the proximal humerus metaphysis
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- Concomitant ipsilateral glenoid fracture Supplementation is typically required for medial calcar comminution
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- Ipsilateral femur fracture Supplementation is typically required to support the medical calcar when there is comminution