The formation of high-mass stars is usually accompanied by powerful protostellar outflows. Such high-mass outflows are not simply scaled-up versions of their lower-mass counterparts, since observations suggest that the collimation degree degrades with stellar mass. Theoretically, the origins of massive outflows remain open to question because radiative feedback and fragmentation of the accretion flow around the most massive stars, with M > 15 M ⊙, may impede the driving of magnetic disk winds. We here present a three-dimensional simulation of the early stages of core fragmentation and massive star formation that includes a subgrid-scale model for protostellar outflows. We find that stars that form in a common accretion flow tend to have ali...