Outcome following Fractures of the Greater Tuberosity of the Humerus: A Retrospective Study

Abstract

Background

There are limited data available on the outcome of patients following isolated fractures of the greater tuberosity of the humerus. In this retrospective study, we looked at how differences with respect to the injury and subsequent management affected patient outcomes.

Methods

Forty-eight (28 men and 20 women) patients (mean age 45 years) who were treated at our institution between 1999 and 2009 matched our inclusion criteria. Thirty-five patients were treated surgically and 13 were managed conservatively. Functional outcome was assessed after a mean follow-up of 5.5 years using the Oxford Shoulder Score (OSS), the University of California and Los Angeles (UCLA) rating scale and the shoulder index of the American Shoulder and Elbow Surgeons (ASES).

Results

Post-fixation displacement of the greater tuberosity fragment of < 5 mm led to a significantly better outcome than displacement > 5 mm (OSS = 43 versus 37; ASES = 25.6 versus 17.7; UCLA 28.2 versus 21.3). Patients who had surgery > 2 weeks after the initial injury had a significantly worse outcome than those who had surgery in < 2 weeks (OSS = 37.4 versus 44.7; ASES = 18.9 versus 27.2). Patients with shoulder dislocation had worse outcome than those with no dislocation (OSS = 40.6 versus 44; ASES 22.9 versus 26) and rotator cuff tears were also associated with worse outcome scores than those without (OSS 42.8 versus 36.8; ASES 24.5 versus 20.5), although neither of these variables proved statistically significant.

Conclusions

Isolated fractures of the greater tuberosity have a worse outcome if there is a delay in surgical fixation of > 2 weeks and post-fixation displacement of > 5 mm.