Journal of Musculoskeletal Trauma

Clinical Features and Characteristics of Greater Tuberosity Fractures with or without Shoulder Dislocation: Dong Wan Kim, Young Jae Lim, Ki Cheor Bae, Beom Soo Kim, Yong Ho Lee, Chul Hyun Cho; J Korean Fract Soc 2018;31(4):139-144. Published online October 31, 2018; DOI: https://doi.org/10.12671/jkfs.2018.31.4.139

Abstract PDF: 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.

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Clinical Results of Various Surgical Techniques for Isolated Fracture of Greater Tuberosity of Humerus: Nam Su Cho, Seong Cheol Moon, Yong Girl Rhee; J Korean Fract Soc 2013;26(2):133-139. Published online April 30, 2013; DOI: https://doi.org/10.12671/jkfs.2013.26.2.133

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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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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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; J Korean Fract Soc 2009;22(3):159-165. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.159

Abstract PDF

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.

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Outcomes of open reduction and internal fixation using 2.0/2.4 mm locking compression plate in isolated greater tuberosity fractures of humerus
Sung Choi, Dongju Shin, Sangwoo Kim, Byung Hoon Kwack
Journal of Musculoskeletal Trauma.2025; 38(1): 32. CrossRef

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The Surgical Outcomes for Isolated Greater Tuberosity Fracture of Proximal Humerus: Eun Sun Moon, Myung Sun Kim, Young Jin Kim; J Korean Fract Soc 2007;20(3):239-245. Published online July 31, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.3.239

Abstract PDF

PURPOSE
To evaluate the adequate surgical methods and postoperative rehabilitation by analyzing the outcome of surgical treatment for isolated greater tuberosity fracture of proximal humerus.
MATERIALS AND METHODS
Ten patients who allowed at least 1 year follow up after the surgical treatment of isolated greater tuberosity fractures were evaluated. Their mean age was 52.3 years (range, 28~67) and mean follow up duration was 23.8 months (range, 12~36). We choosed the different approaches and fixation methods according to size, location and presence of comminution of the fragment, and combined injury. The rehabilitation programs were indivisualized and we evaluated the clinical outcomes using UCLA and Constant scoring system.
RESULTS
According to the UCLA scoring system, 5 cases were excellent, 3 cases were satisfactory, and 2 cases were unsatisfactory. By the Constant scoring system, 8 cases were excellent and 2 cases were good. The average bony union time was 7.6 weeks (range, 6~8) except the 2 cases of revision surgery. Two cases were operated using cannulated screws alone, 3 cases using only nonabsorbable sutures and 5 cases using cannulated screws and nonabsorbable sutures. One out of two revision cases was developed from the negligence of preoperative shoulder anterior dislocation with rupture of subscapularis, and the other was caused by improper immobilization of the fracture site postoperatively.
CONCLUSION
Not only the adequate surgical approaches and the fixation methods according to the size and comminution of fragment, but also the identification of combined injuries were very important in the surgical treatment for the isolated greater tuberosity fracture. And we considered that the adequate postoperative rehabilitation and proper protection based on the intraoperative fixation stability play an important role for the better clinical and radiological outcomes.

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Clinical Features and Characteristics of Greater Tuberosity Fractures with or without Shoulder Dislocation
Dong-Wan Kim, Young-Jae Lim, Ki-Cheor Bae, Beom-Soo Kim, Yong-Ho Lee, Chul-Hyun Cho
Journal of the Korean Fracture Society.2018; 31(4): 139. CrossRef
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
Journal of the Korean Fracture Society.2009; 22(3): 159. CrossRef

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Radiologic assessment of the displacement of the greater tuberosity of the humerus: Jaedoo Yoo, Jangwoon Shon; J Korean Soc Fract 2001;14(2):223-227. Published online April 30, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.2.223

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the correlation between the amount of displacement of the greater tuberosity of the humerus and the that of the radiographic displacement.
MATERIALS AND METHODS
Dry bones of the scapula, humerus were fixed to the board. After cutting the greater tuberosity, the center of the lesser tuberosity, the anterior and inferior margin of the greater tuberosity fragment, the anterior edge of the bone defect at the greater tuberosity were marked with wire. The humerus were placed in the neutral position, 60 degree internal rotation, 15 degree external rotation, 45 degree abduction, 90 degree abduction. The radiographs were taken in the position of the 5, 10, 15, 20, 25mm posterior superior displacement of the fragment respectively.
RESULTS
The correlation coefficient between the amount of displacement of the greater tuberosity of the humerus and the that of the radiographic displacement were followings; 0.599(p=0.285) in the neutral anterior posterior view, 0.790(p=0.112) in the 60 degree internal rotation view, 0.522(p=0.367) in the 15 degree external rotation view, 0.290(p=0.635) in the 45 degree abduction axillary view, 90 degree abduction axillary view.
CONCLUSION
The 90 abduction axillary view was the most appropriate radiograph to evaluate the amount of displacement of the greater tuberosity of the humerus.

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