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Kim, Lim, Bae, Kim, Lee, and Cho: Clinical Features and Characteristics of Greater Tuberosity Fractures with or without Shoulder Dislocation
Original Article

J Korean Fract Soc 2018;31(4):139-144.

Published online: 10 October 2018

DOI: https://doi.org/10.12671/jkfs.2018.31.4.139

Clinical Features and Characteristics of Greater Tuberosity Fractures with or without Shoulder Dislocation

Dong-Wan Kim, M.D., Young-Jae Lim, M.D.*, Ki-Cheor Bae, M.D., Beom-Soo Kim, M.D., Yong-Ho Lee, M.D., Chul-Hyun Cho, Ph.D., M.D.

*Department of Orthopedic Surgery, Keimyung University School of Medicine, The Open Hospital, Daegu, Korea

Correspondence to: Chul-Hyun Cho, M.D., Ph.D. Department of Orthopedic Surgery, Keimyung University School of Medicine, 56 Dalseong-ro, Jung-gu, Daegu 41931, Korea Tel: +82-53-250-7729 Fax: +82-53-250-7205 E-mail: oscho5362@dsmc.or.kr

Received 10 May 2018       Revised 25 September 2018       Accepted 25 September 2018

Copyright © 2018 The Korean Fracture Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) 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 compare the characteristics and clinical features of greater tuberosity fractures with or without a shoulder dislocation.

Materials and Methods

A total of 108 cases of greater tuberosity fractures (56 cases with shoulder dislocation, 52 cases without shoulder dislocation) were reviewed retrospectively. Age, sex, side, injury mechanism, fracture displacement, fracture morphology, number of fracture fragments, main fragment size, treatment, and combined injuries were investigated.

Results

The age, sex, side, injury mechanism, treatment, and combined injuries were similar in both groups (p>0.05). A statistically significant difference in fracture displacement, fracture morphology, number of fracture fragment, and main fragment size was observed between the two groups (p<0.05).

Conclusion

In greater tuberosity fractures with a shoulder dislocation, the prevalence of fracture displacement was high and the depression type of fractures occurred frequently. In addition, the number and size of the fracture fragment increased. Therefore, an understanding of these fracture patterns will be helpful for deciding treatment and prognosis.

Keywords: Shoulder, Greater tuberosity, Fracture, Dislocation

References

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Fig. 1.
Morphological classification of greater tuberosity fractures. (A) Avulsion-type fracture. (B) Split-type fracture. (C) Depression-type fracture.
jkfs-31-139f1.tif
Table 1.
Characteristics of GT Fractures with or without Shoulder Dislocation
Parameter GT fracture without dislocation GT fracture with dislocation Total p-value
Age (yr) 61.9±16.0 63.9±16.7 108 0.468
Gender       0.125
  Male 22 (42.3) 33 (58.9) 55  
  Female 30 (57.7) 23 (41.1) 53  
Side       0.599
  Right 28 (53.9) 34 (60.7) 62  
  Left 24 (46.1) 22 (39.3) 46  
Injury mechanism       0.006
  Low energy injury 29 (55.8) 40 (71.4) 69  
  Intermediate energy injury 7 (13.5) 12 (21.4) 19  
  High energy injury 16 (30.7) 4 (7.2) 20  
Treatment       0.261
  Conservative 27 (51.9) 22 (39.3) 49  
  Surgery 25 (48.1) 34 (60.7) 59  
Combined injury       0.128
  Yes 19 (36.5) 12 (21.4) 31  
  No 33 (63.5) 44 (78.6) 77  
Concomitant shoulder injury       0.796
  Yes 3 (5.8) 5 (8.9) 8  
  No 49 (94.2) 51 (91.1) 100  
Nerve injury       0.027
  Yes 0 (0) 5 (8.9) 5  
  No 52 (100) 51 (91.1) 103  

Values are presented as mean±standard deviation or number (%). GT: greater tuberosity.

Table 2.
Fracture Pattern in Relation to a Shoulder Dislocation
Parameter GT fracture without dislocation GT fracture with dislocation Total p-value
Displacement (mm)       0.020
  <5 34 (65.4) 23 (41.1) 57  
  ≥5 18 (34.6) 33 (58.9) 51  
Classification       0.001
  Split 22 (42.3) 17 (30.4) 39  
  Avulsion 30 (57.7) 26 (46.4) 56  
  Depression 0 (0) 13 (23.2) 13  
No. of fragment       0.001
  One 40 (76.9) 24 (42.9) 64  
  Two 12 (23.1) 22 (39.3) 34  
  Three 0 (0) 3 (5.4) 3  
  More than three 0 (0) 7 (12.4) 7  
GT fragment size       0.007
  Small (<50%) 12 (23.1) 5 (8.9) 17  
  Medium (50%-75%) 13 (25.0) 6 (10.7) 19  
  Large to complete (≥75%) 27 (51.9) 45 (80.4) 72  

Values are presented as mean±standard deviation or number (%). GT: greater tuberosity.

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