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Original Article
Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus
Nam Su Cho, M.D., Seong Cheol Moon, M.D., Yong Girl Rhee, M.D.
Journal of the Korean Fracture Society 2013;26(2):133-139.
DOI: https://doi.org/10.12671/jkfs.2013.26.2.133
Published online: April 22, 2013

Department of Orthopaedic Surgery, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.

*Department of Orthopaedic Surgery, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, Korea.

Address reprint requests to: Yong Girl Rhee, M.D. Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul 130-702, Korea. Tel: 82-2-958-8359, Fax: 82-2-964-3865, shoulderrhee@hanmail.net
• Received: May 28, 2012   • Revised: July 2, 2012   • Accepted: February 12, 2013

Copyright © 2013 The Korean Fracture Society

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  • 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.
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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.
jkfs-26-133-g001.jpg
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.
jkfs-26-133-g002.jpg
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.
jkfs-26-133-g003.jpg
Table 1
Postoperative Range of Motion
jkfs-26-133-i001.jpg

FF: Forward flexion, ERs: External rotation at the side, IRp: Internal rotation to the posterior.

Table 2
Postoperative Clincal Scores
jkfs-26-133-i002.jpg

KSS: Korean Shoulder Score.

Table 3
Postoperative Complications
jkfs-26-133-i003.jpg

Figure & Data

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    • Biomechanical comparisons of hook plate and screw fixations in split-type greater tuberosity fractures of the humerus
      Fa-Chuan Kuan, Kai-Lan Hsu, Chih-Kai Hong, Yueh Chen, Chen-Hao Chiang, Hao-Ming Chang, Wei-Ren Su
      Journal of Shoulder and Elbow Surgery.2022; 31(6): 1308.     CrossRef

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      Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus
      J Korean Fract Soc. 2013;26(2):133-139.   Published online April 30, 2013
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    Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus
    Image Image Image
    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.
    Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus

    Postoperative Range of Motion

    FF: Forward flexion, ERs: External rotation at the side, IRp: Internal rotation to the posterior.

    Postoperative Clincal Scores

    KSS: Korean Shoulder Score.

    Postoperative Complications

    Table 1 Postoperative Range of Motion

    FF: Forward flexion, ERs: External rotation at the side, IRp: Internal rotation to the posterior.

    Table 2 Postoperative Clincal Scores

    KSS: Korean Shoulder Score.

    Table 3 Postoperative Complications


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