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Abstract
Purpose
To compare the clinical and radiologic outcomes of various surgical techniques for an isolated fracture of greater tuberosity of the humerus.
Materials and Methods
From February 2001 to December 2008, 31 patients, who underwent an operation for isolated greater tuberosity fracture and were followed up for more than 1 year, were enrolled in this study. The mean age at the time of operation was 49.3 years (range, 23-73 years). The operation methods included in this study were as follows: a transosseous suture using nonabsorbable suture material (16 cases), a fixation by cannulated screws (10 cases), tension band wiring (2 cases), bony fragment excision with rotator cuff repair (2 cases), and percutaneous pinning (1 case).
Results
At the last follow-up, the average Constant score was 79.4 and Korean Shoulder Score (KSS) was 81.2. Among the various operation methods used in this study, the transosseous suture had the highest scores with 82.5 in Constant score and 89.3 in KSS. Bone union was achieved at average 10.3 weeks (range, 7-15 weeks), and there were 2 cases in which the reoperation was required due to internal fixation failure. Postoperative shoulder stiffness occurred in 3 cases, and all the cases were done with the deltopectoral approach.
Conclusion
Clinically and radiologically satisfactory results were obtained using various operation techniques for an isolated greater tuberosity fracture of the humerus. The transosseous suture showed relatively better results than the other methods used in this study. To achieve favorable clinical and radiologic results, it is important to select an appropriate surgical approach and fixation method according to the fracture site, degree of displacement, and size of fragment.
Figures and Tables
Fig. 1
(A) Right shoulder antero-posterior view shows isolated humerus greater tuberosity fracture of a 36 years old female patient.
(B) Immediate postoperative radiograph shows the acceptable reduction and fixation by transosseous sutures.
(C) Eight months later, radiograph shows that complete bone union was achieved.
Fig. 2
(A) Right shoulder antero-posterior view of a 53 years old male patient shows isolated humerus greater tuberosity fracture with mild displacement.
(B) Immediate postoperative radiograph shows satisfactory anatomical reduction and fixation by multiple cannulated screws.
(C) Twelve months after surgery, radiograph shows that complete bone union was obtained.
Fig. 3
(A) Left shoulder antero-posterior view of a 51 years old female patient shows reduction failure after fixation by two cannulated screws for isolated humerus greater tuberosity fracture.
(B) Seven months after the revision surgery, radiograph shows that complete bone union was obtained.
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