When a patient comes in with a shattered fracture and you have to figure out where all the pieces go, to put it back together! Similar to putting a puzzle together but a little bit more complex. This is a patient who presented with a fracture/dislocation of her proximal humerus. Head is above and feet are below. Briefly, surgery entails booking open the fracture site between the lesser tuberosity and greater tuberosity using a mallet and chisel, removing the fractured humeral head, placing a metal prosthesis (artificial joint) and then closing the book that you opened (tying the greater and lesser tuberosities back down). Case by @overcomingtheoddsbook