Intra-articular Lesions and Clinical Outcomes in Traumatic Anterior Shoulder Dislocation Associated with Greater Tuberosity Fracture of the Humerus

Lim,  Kuk Pil; Lee,  In Seung; Kim,  In Bo

doi:2017.20.4.195

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Original Article

Clinics in Shoulder and Elbow 2017;20(4):195-200.
DOI: https://doi.org/10.5397/cise.2017.20.4.195 Published online December 31, 2017.

Intra-articular Lesions and Clinical Outcomes in Traumatic Anterior Shoulder Dislocation Associated with Greater Tuberosity Fracture of the Humerus

Kuk Pil Lim, In Seung Lee, In Bo Kim

Department of Orthopedic Surgery, Busan Bumin Hospital, Busan, Korea. zeusibk@naver.com

Received: 17 July 2017 • Revised: 12 October 2017 • Accepted: 30 October 2017

Abstract

BACKGROUND: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus.
METHODS
Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24?105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up.
RESULTS
Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up.
CONCLUSIONS
For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

Key Words: Intra-articular lesions; Traumatic anterior shoulder dislocation; Greater tuberosity fracture

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