Arthroscopic reduction and fixation for isolated greater tuberosity fractures

Abstract

Background: Traditionally, displaced greater tuberosity fractures are treated with open reduction and internal fixation. Arthroscopic treatment and outcome of greater tuberosity fractures is far from comprehensive. The objective of the current study was to assess the surgical procedure and outcome of an arthroscopic method in the treatment of isolated greater tuberosity fractures.

Methods: From January 2006 to December 2009, 23 patients with isolated greater tuberosity fractures were treated with an arthroscopic procedure using three cannulated screws combined with washers. During follow-up, radiographs and the constant shoulder score (CSS) were used to evaluate the outcome.

Results: Three cannulated screws with washers were used to fix the fractured fragment of the greater tuberosity under an arthroscope. All incisions healed at primary intention without infection. The mean duration of follow-up was 20 months (range 18 - 36 months). Fracture fixation was excellent, and fractures healed 2 - 6 months (mean 3.8 months) after surgery. At final follow-up, the CSS was 92 (range 86 - 100).

Conclusions: The described arthroscopic procedure provides anatomical reduction and firm fixation for isolated greater tuberosity fractures. It is a successful and minimally invasive procedure with satisfying therapeutic effects as well as excellent functional recovery.