Percutaneous screw fixation of isolated fractures of the greater tuberosity of the humerus

Author(s): Reda H Elkady and Nagi Fuda

Abstract: Background: The unacceptable treatment outcome of the isolated greater tuberosity fracture of the humerus mainly due to missed diagnosis, ignorance, or when be trivialized.
Patients and Methods: Twelve patients with isolated, displaced fracture of the greater tuberosity of the humerus were treated with closed reduction and percutaneous fixation using one or two screws. The indication for surgery was 3 - 5 mm of displacement in any plane in a mean fragment without comminution. The cause of injury was sports in three patients, motor car accidents in five patients, and hyper abduction-external rotation of the shoulder during a fall in four patients.
Results: Radiographic union of the tuberosity was seen in all fractures. There was no heterotopic bone formation in any patient. Functional results were excellent in 8 patients (Constant score: 90.5%), good in 2 patients (Constant score: 81.5%) and satisfactory in 2 patients (Constant score: 70 %). All patients were satisfied with the outcome and the overall mean Constant score was 85.5%.
Conclusion: Closed reduction and percutaneous fixation of large displaced fragment greater tuberosity fracture of the proximal humerus is a good technique providing stable fixation and less or no soft tissue complications as infection, muscle weakness, and adhesions. The technique should be done by experienced surgeon with intra-operative fluoroscopy. The screw is better used with washer for not to damage the fragment during compression.

DOI: https://doi.org/10.22271/ortho.2017.v3.i4d.36