Year Book: Open Reduction and Internal Fixation of Two-Part Displaced

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Fractures of the Greater Tuberosity of the Proximal Part of the Humerus. Flatow, EL. Cuomo, F. Maday, MG. Miller SR. McIlveen, SJ. Bigliani, LU. Article:|J Bone Joint Surg. 1991. 73-A. pp 1213-1218.. Background.--There have been few reports of 2-part displaced fractures of the greater tuberosity, but they may be more common than the literature suggests. Limited motion and disability may result if the fractures are not diagnosed and treated promptly. Long-term results in 12 patients were examined. Methods.--Of 16 patients who underwent open reduction and internal fixation for a 2-part displaced fracture of the greater tuberosity, 12 were available for follow-up interview, physical examination, and radiographs. Average follow-up was 4.5 years. The 7 men and 5 women had an average age of 53 years; 9 of the injuries resulted from a fall onto the arm. The injuries were reduced surgically because of the presence of 1 cm or more of displacement as seen on radiographs. An anterosuperior deltoid-splitting approach was used in combination with rotation of the humerus to gain exposure of the retracted tuberosity. The tuberosity was fixed with heavy, nonabsorbable sutures, and the rotator cuff was carefully repaired, allowing early passive motion.