Skip to main content
SpringerLink
Log in

Arthroscopic refixation of a combined fracture of the greater and lesser tuberosity of the proximal humerus

  • Shoulder
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Combined fractures of the greater and the lesser tuberosity are very rare injuries. This is a case report on arthroscopic treatment using suture anchors and one distal fixation screw. Clinical and radiographic follow-up showed recovery of active motion and consolidation of the fragments in anatomic positions. Level of evidence V.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Bahrs C, Lingenfelter E, Fischer F, Walters EM, Schnabel M (2006) Mechanism of injury and morphology of the greater tuberosity fracture. J Shoulder Elbow Surg 15:140–147

    Article  PubMed  Google Scholar 

  2. Bahrs C, Rolauffs B, Stuby F, Dietz K, Weise K, Helwig P (2010) Effect of proximal humeral fractures on the age-specific prevalence of rotator cuff tears. J Trauma 69:901–906

    Article  PubMed  Google Scholar 

  3. Bhatia DN, van Rooyen KS, du Toit DF, de Beer JF (2006) Surgical treatment of comminuted, displaced fractures of the greater tuberosity of the proximal humerus: a new technique of double-row suture-anchor fixation and long-term results. Injury 37:946–952

    Article  PubMed  Google Scholar 

  4. Bono CM, Renard R, Levine RG, Levy AS (2001) Effect of displacement of fractures of the greater tuberosity on the mechanics of the shoulder. J Bone Joint Surg Br 83:1056–1062

    Article  PubMed  CAS  Google Scholar 

  5. Bonsell S, Buford DA Jr (2003) Arthroscopic reduction and internal fixation of a greater tuberosity fracture of the shoulder: a case report. J Shoulder Elbow Surg 12:397–400

    Article  PubMed  Google Scholar 

  6. Burkhart SS (2000) A stepwise approach to arthroscopic rotator cuff repair based on biomechanical principles. Arthroscopy 16:82–90

    Article  PubMed  CAS  Google Scholar 

  7. Calvo E, Merino-Gutierrez I, Lagunes I (2010) Arthroscopic tuberoplasty for subacromial impingement secondary to proximal humeral malunion. Knee Surg Sports Traumatol Arthrosc 18:988–991

    Article  PubMed  Google Scholar 

  8. Flatow EL, Cuomo F, Maday MG, Miller SR, McIlveen SJ, Bigliani LU (1991) Open reduction and internal fixation of two-part displaced fractures of the greater tuberosity of the proximal part of the humerus. J Bone Joint Surg Am 73:1213–1218

    PubMed  CAS  Google Scholar 

  9. Gartsman GM, Taverna E, Hammerman SM (1999) Arthroscopic treatment of acute traumatic anterior glenohumeral dislocation and greater tuberosity fracture. Arthroscopy 15:648–650

    Article  PubMed  CAS  Google Scholar 

  10. Greiner S, Scheibel M (2011) Bony avulsions of the rotator cuff: arthroscopic concepts. Orthopade 40(21–24):26–30

    Google Scholar 

  11. Hepp P, Theopold J, Engel T, Marquass B, Dusing T, Josten C (2008) Lesser tuberosity avulsion in combination with multifragment fracture of the greater tuberosity. A rare entity at the proximal humerus. Unfallchirurg 111:628–631

    Article  PubMed  CAS  Google Scholar 

  12. Ji JH, Kim WY, Ra KH (2007) Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures. Arthroscopy 23(1133):e1131–e1134

    Google Scholar 

  13. Ji JH, Moon CY, Kim YY, Shafi M (2009) Arthroscopic fixation for a malunited greater tuberosity fracture using the suture-bridge technique: technical report and literature review. Knee Surg Sports Traumatol Arthrosc 17:1473–1476

    Article  PubMed  Google Scholar 

  14. Ji JH, Shafi M, Song IS, Kim YY, McFarland EG, Moon CY (2010) Arthroscopic fixation technique for comminuted, displaced greater tuberosity fracture. Arthroscopy 26:600–609

    Article  PubMed  Google Scholar 

  15. Kim KC, Rhee KJ, Shin HD, Kim YM (2008) Arthroscopic fixation for displaced greater tuberosity fracture using the suture-bridge technique. Arthroscopy 24(120):e121–e123

    Google Scholar 

  16. Lee SU, Jeong C, Park IJ (2012) Arthroscopic fixation of displaced greater tuberosity fracture of the proximal humerus. Knee Surg Sports Traumatol Arthrosc 20:378–380

    Article  PubMed  Google Scholar 

  17. Mason BJ, Kier R, Bindleglass DF (1999) Occult fractures of the greater tuberosity of the humerus: radiographic and MR imaging findings. AJR Am J Roentgenol 172:469–473

    Article  PubMed  CAS  Google Scholar 

  18. McLaughlin HL (1963) Dislocation of the shoulder with tuberosity fracture. Surg Clin North Am 43:1615–1620

    PubMed  CAS  Google Scholar 

  19. Meyer DC, Espinosa N, Hertel R (2006) Combined fracture of the greater and lesser tuberosities with intact connection of the humeral head to the shaft. J Trauma 61:206–208

    Article  PubMed  Google Scholar 

  20. Ogawa K, Takahashi M (1997) Long-term outcome of isolated lesser tuberosity fractures of the humerus. J Trauma 42:955–959

    Article  PubMed  CAS  Google Scholar 

  21. Park MC, Pirolo JM, Park CJ, Tibone JE, McGarry MH, Lee TQ (2009) The effect of abduction and rotation on footprint contact for single-row, double-row, and modified double-row rotator cuff repair techniques. Am J Sports Med 37:1599–1608

    Article  PubMed  Google Scholar 

  22. Park MC, Tibone JE, ElAttrache NS, Ahmad CS, Jun BJ, Lee TQ (2007) Part II: biomechanical assessment for a footprint-restoring transosseous-equivalent rotator cuff repair technique compared with a double-row repair technique. J Shoulder Elbow Surg 16:469–476

    Article  PubMed  Google Scholar 

  23. Park TS, Choi IY, Kim YH, Park MR, Shon JH, Kim SI (1997) A new suggestion for the treatment of minimally displaced fractures of the greater tuberosity of the proximal humerus. Bull Hosp Jt Dis 56:171–176

    PubMed  CAS  Google Scholar 

  24. Pujol N, Fong O, Scharycki S, Remi J, Beaufils P, Boisrenoult P (2009) Simultaneous arthroscopic treatment of displaced greater tuberosity and glenoid fracture using a double-row technique. Knee Surg Sports Traumatol Arthrosc 17:1508–1510

    Article  PubMed  Google Scholar 

  25. Scheibel M, Martinek V, Imhoff AB (2005) Arthroscopic reconstruction of an isolated avulsion fracture of the lesser tuberosity. Arthroscopy 21:487–494

    Article  PubMed  Google Scholar 

  26. Song HS, Williams GR Jr (2008) Arthroscopic reduction and fixation with suture-bridge technique for displaced or comminuted greater tuberosity fractures. Arthroscopy 24:956–960

    Article  PubMed  Google Scholar 

  27. Takase K, Shinmura K, Yamamoto K (2007) A combined fracture of the greater and lesser tuberosity with head shaft continuity in the proximal humerus. Arch Orthop Trauma Surg 127:895–898

    Article  PubMed  Google Scholar 

  28. Taverna E, Sansone V, Battistella F (2004) Arthroscopic treatment for greater tuberosity fractures: rationale and surgical technique. Arthroscopy 20:e53–e57

    Article  PubMed  Google Scholar 

  29. van Laarhoven HA, te Slaa RL, van Laarhoven EW (1995) Isolated avulsion fracture of the lesser tuberosity of the humerus. J Trauma 39:997–999

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

None of the authors or their families have received any financial payments or other benefits from any commercial entity related to the subject of this article and have no potential conflicts of interest related to this manuscript.

Author information

Authors and Affiliations

  1. Center for Musculoskeletal Surgery, Charité-Universitaetsmedizin, Charitéplatz 1, 10117, Berlin, Germany

    S. Pauly, S. Herrmann, C. Perka & S. Greiner

Authors
  1. S. Pauly
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. Herrmann
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. C. Perka
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. S. Greiner
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to S. Greiner.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pauly, S., Herrmann, S., Perka, C. et al. Arthroscopic refixation of a combined fracture of the greater and lesser tuberosity of the proximal humerus. Knee Surg Sports Traumatol Arthrosc 21, 1171–1175 (2013). https://doi.org/10.1007/s00167-012-2033-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-012-2033-3

Keywords

Search

Navigation