Mechanism of injury and morphology of the greater tuberosity fracture

Bahrs, Christian; Lingenfelter, Erich J.; Fischer, Friedrich; Walters, Eduard M.; Schnabel, M.

doi:10.1016/j.jse.2005.07.004

Cited by 102 publications

(54 citation statements)

References 38 publications

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“…It has been reported that isolated greater tuberosity fractures account for 17% to 21% of proximal humeral fractures [2,11] and 15% to 30% of glenohumeral dislocations [11]. Even a small amount of displacement can affect shoulder function [11,30].…”

Section: Introductionmentioning

confidence: 99%

Is Arthroscopic Technique Superior to Open Reduction Internal Fixation in the Treatment of Isolated Displaced Greater Tuberosity Fractures?

Liao¹,

Zhang²,

Li³

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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Background Arthroscopic double-row suture-anchor fixation and open reduction and internal fixation (ORIF) are used to treat displaced greater tuberosity fractures, but there are few data that can help guide the surgeon in choosing between these approaches. Questions/Purposes We therefore asked: (1) Is there a difference in surgical time between arthroscopic doublerow suture anchor fixation and ORIF for isolated displaced greater tuberosity fractures? (2) Are there differences in the postoperative ROM and functional scores between arthroscopic double-row suture anchor fixation and ORIF for isolated displaced greater tuberosity fractures? (3) Are there differences in complications resulting in additional operations between the two approaches?Methods Between 2006 and 2012, we treated 79 patients surgically for displaced greater tuberosity fractures. Of those, 32 (41%) were considered eligible for our study based on inclusion criteria for isolated displaced greater tuberosity fractures with a displacement of at least 5 mm but less than 2 cm. During that time, we generally treated patients with displaced greater tuberosity fractures with a displacement greater than 1 cm or with a fragment size greater than 393 cm with open treatment, and patients with displaced greater tuberosity fractures with a displacement less than 1 cm or with a fragment size less than 393 cm with arthroscopic treatment. Fifty-three underwent open treatment based on those indications, and 26 underwent arthroscopic treatment, of whom 17 (32%) and 15 (58%) were available for followup at a mean of 34 months (range, 24-28 months). All patients with such fractures identified from our institutional database were treated by these two approaches and no other methods were used. Surgical time was defined as the time from initiation of the incision to the time when suture of the incision was finished, and was determined by an observer with a stopwatch. Patients were followed up in the outpatient department at 6, 12, and 24 weeks, and every 6 month thereafter. Radiographs showed optimal reduction immediately after surgery and at every followup. Radiographs were obtained to assess fracture healing. Patients were followed up for a mean of 34 months (range, 24-48 months). At the last followup, ROM, VAS score, and American Shoulder and Elbow Surgeons (ASES) score were used to evaluate clinical outcomes. All these data were retrieved from our institutional database through chart review. Complications were assessed through chart review by one observer other than the operating surgeon.

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Section: Introductionmentioning

confidence: 99%

Is Arthroscopic Technique Superior to Open Reduction Internal Fixation in the Treatment of Isolated Displaced Greater Tuberosity Fractures?

Liao¹,

Zhang²,

Li³

et al. 2016

Clinical Orthopaedics &Amp; Related Research

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show abstract

“…Bahrs et al investigated the morphology and mechanisms of greater tuberosity fractures and found that 59/103 (57.2%) were associated with shoulder dislocations (17). Therefore, paying attention to all accompanying fractures is necessary in the management of shoulder dislocations.…”

Section: Discussionmentioning

confidence: 99%

Irreducible Anterior Shoulder Dislocation Associated With Displaced Fracture of the Greater Tuberosity: An Analysis of Seven Cases

Amroodi

2015

Shafa Ortho J

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Background: Although anterior shoulder dislocation is the most prevalent type of body dislocation, irreducible anterior shoulder dislocation is seldom reported in the literature, which is usually due to physical obstacles. Objectives: This study presents our findings regarding the causes of irreducibility of anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Patients and Methods:CT scans, open reduction of the joint, and internal fixation of the tuberosity was performed in seven patients with irreducible anterior shoulder dislocation associated with displaced fracture of the greater tuberosity. Results: As confirmed by intraoperative findings, the CT scans showed the cause of irreducible shoulder dislocation in six cases was the interposition of the long head of biceps (LHB) in the anterior of the head that was displaced from the fracture line between the greater and lesser tuberosities. In another case, the greater and lesser tuberosities were attached to each other and were separated from the head. This fractured part was trapped. Conclusions: We suggest that performing CT scans in all cases of anterior shoulder dislocations with displaced fracture of the greater tuberosity can help surgeons to diagnose the accompanying fractures and possible complications, such as irreducibility. If the fracture line passes through the bicipital groove or in the case of a shield fracture, possible irreducibility should be borne in mind.

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“…Among proximal humeral fractures, isolated fractures of the greater tuberosity are rare and fractures of the lesser tuberosity are exceedingly rare [1].…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic refixation of a combined fracture of the greater and lesser tuberosity of the proximal humerus

Pauly

Herrmann

Perka

et al. 2012

Knee Surg Sports Traumatol Arthrosc

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Mechanism of injury and morphology of the greater tuberosity fracture

Cited by 102 publications

References 38 publications

Is Arthroscopic Technique Superior to Open Reduction Internal Fixation in the Treatment of Isolated Displaced Greater Tuberosity Fractures?

Is Arthroscopic Technique Superior to Open Reduction Internal Fixation in the Treatment of Isolated Displaced Greater Tuberosity Fractures?

Irreducible Anterior Shoulder Dislocation Associated With Displaced Fracture of the Greater Tuberosity: An Analysis of Seven Cases

Arthroscopic refixation of a combined fracture of the greater and lesser tuberosity of the proximal humerus

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