Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus

J Am Acad Orthop Surg. 2016 Jan;24(1):46-56. doi: 10.5435/JAAOS-D-14-00289.

Abstract

Greater tuberosity fractures of the humerus can be successfully treated nonsurgically in most patients. However, as little as 3 to 5 mm of superior greater tuberosity displacement may adversely affect rotator cuff biomechanics and lead to subacromial impingement in patients who are active. In these cases, surgical treatment is recommended. Multiple surgical techniques include open and arthroscopic options tailored to fracture morphology, and strategies for repair include the use of suture anchors, transosseous sutures, tension bands, and plates/screws. Three classification systems are commonly used to describe greater tuberosity fractures: the AO, Neer, and morphologic classifications. Several hypotheses have been discussed for the mechanism of greater tuberosity fractures and the deforming forces of the rotator cuff, and the use of advanced imaging is being explored.

Publication types

  • Review

MeSH terms

  • Arthroscopy / instrumentation
  • Arthroscopy / methods*
  • Biomechanical Phenomena
  • Bone Plates
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Humans
  • Humerus / injuries
  • Humerus / surgery*
  • Rotator Cuff / surgery
  • Rotator Cuff Injuries
  • Shoulder Dislocation / surgery*
  • Shoulder Fractures / classification
  • Shoulder Fractures / complications
  • Shoulder Fractures / surgery*
  • Shoulder Impingement Syndrome / etiology
  • Shoulder Impingement Syndrome / surgery
  • Suture Anchors
  • Suture Techniques
  • Sutures
  • Treatment Outcome