Skip to main content
SpringerLink
Log in

Arthroscopy-Assisted Reduction-Internal Fixation in Greater and Lesser Humeral Tuberosity Fracture

  • Chapter
  • First Online:
Intraarticular Fractures

  • 678 Accesses

Abstract

Proximal humeral fractures are usually treated with open reduction and internal fixation. Many studies have reported satisfactory results; however, complications related to open procedures have been reported. These include the need for extensive soft tissue dissection to obtain adequate fracture fragment visualization and difficulties associated with effective, direct fracture reduction and fixation. Prolonged shoulder immobilization, deltoid muscle detachment from the acromion process, and axillary nerve injury risk are all related to increased shoulder stiffness.

Rapidly developing arthroscopy-assisted technologies have led to its greater use to assist with greater and lesser humeral tuberosity fracture management. A primary advantage of an arthroscopy-assisted surgical approach is that it minimizes the amount of soft tissue dissection needed to obtain sufficient fracture exposure and visualization for effective fracture reduction and fixation.

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

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 179.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  • Atesok K, Doral MN, Whipple T et al (2011) Arthroscopy assisted fracture fixation. Knee Surg Sports Traumatol Arthrosc 19:320–329

    Article  Google Scholar 

  • Bahrs C, Lingenfelter E, Fischer F et al (2006) Mechanism of injury and morphology of the greater tuberosity fracture. J Shoulder Elbow Surg 15:140–147

    Article  Google Scholar 

  • Barnes LA, Passons BO, Flatow EL (2010) Overview of shoulder approaches: choosing between mini incision and arthroscopy technique. In: Scuderi GR, Tria AJ (eds) Minimally invasive surgery in orthopedics. Springer, New York, pp 91–95

    Google Scholar 

  • Baudi P, Campochiaro G, Rebuzzi M, Serafini F, Matino G, Catani F (2015) The tuberosities. In: Castoldi F, Blonna D, Assom M (eds) Simple and complex fracture of the humerus: a guide to assessment and treatment. Springer Verlag, Mailand, pp 143–162

    Google Scholar 

  • Bigliani LU, Flatow EL (1998) Fractures of the proximal humerus. In: Rockwood CA, Matsen FA (eds) The shoulder, 3rd edn. WB Saunders, Philadelphia, pp 337–389

    Google Scholar 

  • Giudici LD, Faini A, Garro L, Tucciarone A, Gigante A (2017) Arthroscopic management of articular and peri-articular fracture of the upper limb. EFORT Open Rev 1:325–331

    Article  Google Scholar 

  • Goeminne S, Debeer P (2012) The natural evolution of neglected lesser tuberosity fractures in skeletally immature patients. J Shoulder Elbow Surg 21:e6–e11

    Article  Google Scholar 

  • Green A, Izzi J Jr (2003) Isolated fractures of the greater tuberosity of the proximal humerus. J Shoulder Elbow Surg 12:641–649

    Article  Google Scholar 

  • Gruson KI, Ruchelsman DE, Tejwani NC (2008) Isolated tuberosity fractures of the proximal humerus: current concepts. Injury 39:284–298

    Article  Google Scholar 

  • Horak J, Nilsson BE (1975) Epidemiology of fracture of the upper end of humerus. Clin Orthop Relat Res 112:250–253

    Article  Google Scholar 

  • de Laat EA, Visser CP, Coene LN, Pahlplatz PV, Tavy DL (1994) Nerve lesions in primary shoulder dislocations and humeral neck fractures: a prospective clinical and EMG study. J Bone Joint Surg Br 76:381–383

    Article  Google Scholar 

  • Lewis RG, Scalamogna D, Patel P (2015) Tuberosity fracture. In: Crosby LA, Neviaser RJ (eds) Proximal humeral fractures: evaluation and management. Springer International Publishing, Basel, pp 55–72

    Google Scholar 

  • Li R, Cai M, Tao K (2017) Arthroscopic reduction and fixation for displaced greater tuberosity fracture using modified suture-bridge technique. Int Orthop 41:1257–1263

    Article  Google Scholar 

  • Liao W, Zhang H, Li Z (2016) Is Arthroscopic technique superior to open reduction internal fixation in the treatment of isolated displaced greater tuberosity fractures? Clin Orthop Relat Res 474:1269–1279

    Article  Google Scholar 

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

    Article  CAS  Google Scholar 

  • Mora Guix JM, Gonzalez AS, Brugalla JV et al (2006) Proposed protocol for reading images of humeral head fractures. Clin Orthop Relat Res 448:225–233

    Article  Google Scholar 

  • Neer CS II (1970) Displaced proximal humeral fractures. Part I Classification and evaluation. J Bone Joint Surg Am 52:1077–1092

    Article  Google Scholar 

  • Neogi DS, Bejjanki N, Ahrens PM (2013) The consequences of delayed presentation of lesser tuberosity avulsion fractures in adolescents after repetitive injury. J Shoulder Elbow Surg 22:e1–e5

    Article  Google Scholar 

  • Park TS, Choi IY, Kim Y et al (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

    CAS  PubMed  Google Scholar 

  • Patten RM, Mack LA, Wang KY, Lingel J (1992) Nondisplaced fractures of the greater tuberosity of the humerus: sonographic detection. Radiology 182:201–204

    Article  CAS  Google Scholar 

  • Resch H, Kathrein A, Golser K et al (1992) Arthroscopic and percutaneous bone screw techniques with a new screw system. Unfallchirurg 95:91–98

    CAS  PubMed  Google Scholar 

  • Robinson CM, Aderinto J (2005) Posterior shoulder dislocations and fracture-dislocations. J Bone Joint Surg Am 87:639–650

    Article  Google Scholar 

  • Schai PA, Hintermann B, Koris MJ (1999) Preoperative arthroscopic assessment of fractures about the shoulder. Arthroscopy 15:827–835

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  • Toolanen G, Hildingsson C, Hedlund T, Knibestöl M, Oberg L (1993) Early complications after anterior dislocation of the shoulder in patients over 40 years: an ultrasonographic and electromyographic study. Acta Orthop Scand 64:549–552

    Article  CAS  Google Scholar 

  • Vester H, Lenich A, Imhoff AB (2015) Arthroscopic options for treatment of proximal humeral fractures. In: Biberthaler P, Kirchhoff C, Wadell JP (eds) Fracture of proximal humerus. Springer International Publishing, Basel, pp 123–131

    Google Scholar 

  • Willis AA, Verma NN, Thornton SJ, Morrissey NJ, Warren RF (2005) Upper-extremity deep-vein thrombosis after anterior shoulder dislocation and closed reduction: a case report. J Bone Joint Surg Am 87:2086–2090

    Article  Google Scholar 

  • Zanetti M, Weishaupt D, Jost B et al (1999) MR imaging for traumatic tears of the rotator cuff: high prevalence of greater tuberosity fractures and subscapularis tendon tears. AJR Am J Roentgenol 172:463–467

    Article  CAS  Google Scholar 

  • Zuckerman JD, Flugstad DL, Teitz CC, King HA (1984) Axillary artery injury as a complication of proximal humeral fractures: two case reports and a review of the literature. Clin Orthop Relat Res 189:234–237

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopaedics Surgery, Faculty of Medicine, Thammasat University, Rangsit, Pathumtani, Thailand

    Bancha Chernchujit

  2. Department of Orthopaedic and Traumatology, Faculty of Medicine, Universitas Padjadjaran—RS Dr. Hasan Sadikin, Bandung, Indonesia

    Renaldi Prasetia

Authors
  1. Bancha Chernchujit
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Renaldi Prasetia
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Orthopedics and Traumatology, T.C. Ufuk University, Ankara, Turkey

    Mahmut Nedim Doral

  2. Department of Orthopaedics, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden

    Jón Karlsson

  3. Kosair Charities College of Health and Natural Sciences, Spalding University, Louisville, KY, USA

    John Nyland

  4. Helfentalweg 1A, Landeskrankenhaus Feldkirch Abt. Unfallchirurgie, Innsbruck, Austria

    Karl Peter Benedetto

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chernchujit, B., Prasetia, R. (2019). Arthroscopy-Assisted Reduction-Internal Fixation in Greater and Lesser Humeral Tuberosity Fracture. In: Doral, M., Karlsson, J., Nyland, J., Benedetto, K. (eds) Intraarticular Fractures. Springer, Cham. https://doi.org/10.1007/978-3-319-97602-0_13

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-97602-0_13

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-97600-6

  • Online ISBN: 978-3-319-97602-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation