The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate

Dong-Ju Shin; Young-Soo Byun; Se-Ang Chang; Hee-Min Yun; Ho-Won Park; Jae-Young Park

doi:10.12671/jkfs.2009.22.3.159

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Shin, Byun, Chang, Yun, Park, and Park: The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate

Original Article

Journal of the Korean Fracture Society 2009; 22(3): 159-165.

Published online: 31 July 2009

DOI: https://doi.org/10.12671/jkfs.2009.22.3.159

The Surgical Outcomes of Isolated Greater Tuberosity Fractures of the Proximal Humerus Fixed with the Spring Plate

Dong-Ju Shin, M.D., Young-Soo Byun, M.D., Se-Ang Chang, M.D., Hee-Min Yun, M.D., Ho-Won Park, M.D., Jae-Young Park, M.D.

Department of Orthopedic Surgery, Daegu Fatima Hospital, Daegu, Korea.

Address reprint requests to: Young-Soo Byun, M.D. Department of Orthopaedic Surgery, Daegu Fatima Hospital, 576-31, Sinam-dong, Dong-gu, Daegu 701-600, Korea. Tel: 82-53-940-7320, Fax: 82-53-940-7417, fatimaos@unitel.co.kr

Received 22 January 2009 Revised 20 April 2009 Accepted 30 June 2009

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to evaluate the surgical outcomes of isolated greater tuberosity fractures of the proximal humerus fixed with the spring plates.

Materials and Methods

Fourteen patients who could be followed up at least 1 year after the surgical treatment of isolated greater tuberosity fracture were evaluated. Their mean age was 51 years (range, 25~73 years). The deltopectoral approach and fixation with the spring plate were performed in all cases. The spring plate was used in all cases. In some circumstances, sutures incorporating the rotator cuff, interfragmentary screw or tension band wire were added. We evaluated the clinical outcomes using UCLA scoring system and KSS (Korean Shoulder Score).

Results

The mean UCLA score was 29.8 and the mean KSS was 89.4. The average time of bony union was 10.2 weeks (range, 7~14 weeks) after the surgery, including 1 case that was performed the secondary operation due to metal failure. The shoulder stiffness were observed in 4 cases and one case of infection was treated well without operation.

Conclusion

In the treatment of isolated greater tuberosity fractures of the proximal humerus, the spring plates fixation can be a good surgical option providing reliable functional results.

Keywords: Humerus, Isolated greater tuberosity fracture, Spring plate

Figures and Tables

Fig. 1

(A~D) These photographs show the manufacturing process of spring plate. A appropriate-sized 1/3 tubular plate was selected, and cut at the end of screw hole.

Fig. 2

A 49-years-old male sustained a isolated greater tuberosity fracture of the proximal humerus by a fall on the ground.

(A) Preoperative radiograph shows a displaced greater tuberosity fracture of the proximal humerus.

(B) Postoperative immediate radiograph shows good reduction and fixation of the fracture with a spring plate.

(C) Postoperative 7 weeks radiograph shows solid union without implant loosening and loss of reduction.

(D~G) Photographs show near symmetric full forward flexion and internal rotation at final follow-up (postoperative 12 months).

Fig. 3

A 44-years-old male sustained multiple extremity fractures and subdural hemorrhage by a fall from a height. He lost his consciousness for several weeks.

(A) Eight weeks after trauma, a displaced greater tuberosity fracture of the proximal humerus was noticed on radiograph.

(B, C) Reconstructed three-dimensional computerized tomography scans show marked displacement of fracture fragment impinging into subacromial space.

(D) Postoperative immediate radiograph shows good reduction and fixation of the fracture with a spring plate.

(E) Postoperative 13 weeks radiograph shows solid union without implant loosening and loss of reduction.

Table 1

Patient demographics

M: Male, F: Female, DM: Diabetus mellitus, RA: Rheumatoid arthritis, HTN: Hypertension, MF: Multiple fracture, SD: Shoulder dislocation, SDH: Subdural hemorrhage, BPI: Brachial plexus injury, TBW: Tension band wire.

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