Outcomes of surgical fixation of greater tuberosity fractures: A systematic review

Huntley, Samuel; Lehtonen, Eva; Robin, Joseph X.; Arguello, Alexandra M.; Rouleau, Dominique M.; Brabston, Eugene W.; Ponce, Brent A.; Momaya, Amit

doi:10.1016/j.otsr.2020.05.005

Cited by 20 publications

(18 citation statements)

References 41 publications

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“…1 These fractures may be more challenging to identify on initial plain radiographs because of osseous overlap when the glenohumeral joint is internally rotated. Additionally, small comminuted fragments may simply be overlooked or misinterpreted as calcific deposition within the rotator cuff or intra-articular loose bodies, 1 so that its true incidence may therefore be higher. 1 The demographics of patients who sustain isolated GT fractures have been more extensively reviewed, and their occurrence is predominantly in young male patients.…”

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confidence: 99%

“…Additionally, small comminuted fragments may simply be overlooked or misinterpreted as calcific deposition within the rotator cuff or intra-articular loose bodies, 1 so that its true incidence may therefore be higher. 1 The demographics of patients who sustain isolated GT fractures have been more extensively reviewed, and their occurrence is predominantly in young male patients. 1 The treatment of this kind of fracture is controversial.…”

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confidence: 99%

“…1 The demographics of patients who sustain isolated GT fractures have been more extensively reviewed, and their occurrence is predominantly in young male patients. 1 The treatment of this kind of fracture is controversial. Generally nondisplaced or minimally displaced fractures are treated conservatively.…”

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confidence: 99%

“…Fractures of the proximal humerus represent approximately 5% of all fractures and almost half of all humeral fractures. 1 The 20% of the latter are represented by isolated fractures of the greater tuberosity (GT). 1 These fractures may be more challenging to identify on initial plain radiographs because of osseous overlap when the glenohumeral joint is internally rotated.…”

mentioning

confidence: 99%

“… 1 The 20% of the latter are represented by isolated fractures of the greater tuberosity (GT). 1 These fractures may be more challenging to identify on initial plain radiographs because of osseous overlap when the glenohumeral joint is internally rotated. Additionally, small comminuted fragments may simply be overlooked or misinterpreted as calcific deposition within the rotator cuff or intra-articular loose bodies, 1 so that its true incidence may therefore be higher.…”

mentioning

confidence: 99%

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Fracture Avulsion of the Greater Tuberosity: Arthroscopic Transosseous Augmented Technique

Chillemi

Proietti

Rengo

et al. 2021

Arthroscopy Techniques

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The fracture avulsion of the greater tuberosity (GT) represents 2% of all humerus fractures, but the true incidence is likely to be higher, being challenging the initial diagnosis on radiograph. The fracture avulsion of the GT could have different treatments: nondisplaced or minimally displaced fractures are treated conservatively, whereas for displaced or comminuted fractures surgical treatment is preferred. The most important finding of this study is the employment of an all-arthroscopic transosseous augmented technique for the treatment of a displaced humeral GT fracture avulsion. This technique shows all the advantages of the transosseous fixation and arthroscopic approach.

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confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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confidence: 99%

mentioning

confidence: 99%

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Fracture Avulsion of the Greater Tuberosity: Arthroscopic Transosseous Augmented Technique

Chillemi

Proietti

Rengo

et al. 2021

Arthroscopy Techniques

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Excellent clinical and radiological outcomes after arthroscopic reduction and double row‐suture bridge for large‐sized greater tuberosity fractures of the humerus

Ko,

Oh,

Park

et al. 2024

Knee surg. sports traumatol. arthrosc.

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PurposeCurrently, there is limited information on the clinical outcomes of arthroscopic reduction and double‐row suture bridge fixation for large greater tuberosity fractures of the proximal humerus. This study aimed to evaluate the radiological and clinical outcomes of arthroscopic reduction and double‐row suture bridge fixation for these fractures, hypothesizing that arthroscopic reduction and double‐row suture bridge fixation is a safe, effective and minimally invasive treatment for large greater tuberosity fractures.MethodsThis retrospective study analysed patients with large greater tuberosity fractures (fracture fragment ≥30 mm in diameter) who underwent arthroscopic reduction and double‐row suture bridge fixation and had a follow‐up period exceeding 2 years. The anatomic reduction was confirmed by assessing the step‐off on radiographs immediately after surgery, and the radiologic union time was recorded. At the final follow‐up, range of motion and functional outcome scores were evaluated. Additionally, any surgery‐related complications were evaluated.ResultsFifteen patients with a mean follow‐up of 57.7 ± 23.1 months were included in the study. The mean fracture fragment size was 32.5 ± 2.4 mm, with a mean displacement of 5.1 ± 1.6 mm. Immediately postsurgery, 13 of 15 patients (86.7%) had a fracture step‐off of <3 mm, with an average union time of 3 months. At the final follow‐up, patients demonstrated excellent outcomes, with an average forward flexion of 167 ± 9.7° and external rotation of 70 ± 16.3. Functional outcome scores showed significant improvement compared with preoperative scores (p < 0.001). No major surgery‐related complications were reported.ConclusionsArthroscopic reduction and double‐row suture bridge fixation for large‐sized greater tuberosity fractures is safe and shows good fracture reduction and excellent clinical outcomes. Therefore, this surgical method can be considered an alternative to open reduction for large greater tuberosity fractures.Level of EvidenceLevel IV.

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Sports-Related Shoulder Fractures: Diagnosis, Management, and Rehabilitation

Evan,

Kevin,

Dave

et al. 2024

Sports Injuries

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Outcomes of surgical fixation of greater tuberosity fractures: A systematic review

Cited by 20 publications

References 41 publications

Fracture Avulsion of the Greater Tuberosity: Arthroscopic Transosseous Augmented Technique

Fracture Avulsion of the Greater Tuberosity: Arthroscopic Transosseous Augmented Technique

Excellent clinical and radiological outcomes after arthroscopic reduction and double row‐suture bridge for large‐sized greater tuberosity fractures of the humerus

Sports-Related Shoulder Fractures: Diagnosis, Management, and Rehabilitation

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