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R econstruction after resection of proximal humerus bone sarcomas in children poses a unique challenge for orthopaedic surgeons. In most cases, the rotator cuff, axillary nerve, and portions of the deltoid must be removed. Instability, even with a reverse shoulder arthroplasty configuration, is also a major concern. Despite these challenges, our goal should be a durable reconstruction, ideally one that lasts for the lifetime of the patient. While we can cure most patients with bone sarcomas in the proximal humerus, restoring function can be a trying process. Any reconstruction should provide joint stability as well as the ability to position the hand from forehead to buttocks, permitting grooming, eating, and personal hygiene. Reconstruction might also allow patients to return to competitive non-overhead sports. Alternative treatment options include allografts, allograft-prosthetic composites, endoprosthetics, and free vascularized fibulae. Each has its advantages and disadvantages, and all are associated with real risks of complications. As far as we can tell, the ROM a patient might achieve after surgery seems more dependent upon the extent of the resection than on the particular reconstruction itself. The clavicula pro humero technique is an attractive alternative surgical option that enables the use of native anatomy to produce a stable, and potentially durable, shoulder reconstruction. This approach is certainly not without its complications, with nonunion, fracture, and pseudarthrosis being most common. The clavicula pro humero technique is performed more commonly in less-developed countries; my first exposure to this procedure was during a visit to a hospital ward in Limpopo, South Africa in 2005 where dozens of abandoned children who had survived their sarcoma resections were participating in aggressive-but-friendly basketball games and soccer matches. Even so, patients in countries where all reconstructive options are available This CORR Insights is a commentary on the article ‘‘Is the Clavicula Pro Humero Technique of Value for Reconstruction After Resection of the Proximal Humerus in Children?’’ by Barbier and colleagues available at: DOI: 10.1007/s11999-017-5438-y. The author certifies that neither he, nor any members of his immediate family, have any commercial associations (such as consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR or The Association of Bone and Joint Surgeons. This CORR Insights comment refers to the article available at DOI: 10.1007/s11999017-5438-y.

CORR Insights®: Is the Clavicula Pro Humero Technique of Value for Reconstruction After Resection of the Proximal Humerus in Children?