Isolated tuberosity fractures of the proximal humeral: Current concepts

Konrad I. Gruson, David E. Ruchelsman, Nirmal C. Tejwani

Research output: Contribution to journalReview article

67 Scopus citations

Abstract

Despite the relatively common occurrence of fractures of the proximal humeral amongst the elderly, the subgroup of isolated greater and lesser tuberosity fractures have remained less well understood. While the majority of two-part fractures result from a standing-height fall onto an outstretched hand, isolated tuberosity fractures are also commonly associated with glenohumeral dislocations or direct impact to the shoulder region. Inasmuch as isolated greater tuberosity fractures are considered uncommon, isolated lesser tuberosity fractures are generally considered exceedingly rare. Non-operative treatment including a specific rehabilitation protocol has been advocated for the majority of non-displaced and minimally displaced fractures, with generally good outcomes expected. The treatment for displaced fractures, however, has included both arthroscopically assisted fixation and open or percutaneous reduction and internal fixation (ORIF). The choice of fixation and approach depends not only on fracture type and characteristics, but also on a multitude of patient-related factors. With an expected increase in the level of physical activity across all age groups and overall longer lifespans, the incidence of isolated tuberosity fractures of the proximal humeral is expected to rise. Orthopaedic surgeons treating shoulder trauma should be aware of treatment options, as well as expected outcomes.

Original languageEnglish (US)
Pages (from-to)284-298
Number of pages15
JournalInjury
Volume39
Issue number3
DOIs
StatePublished - Mar 1 2008
Externally publishedYes

Keywords

  • Greater tuberosity fracture
  • Lesser tuberosity fracture
  • Proximal humeral fracture

ASJC Scopus subject areas

  • Emergency Medicine
  • Orthopedics and Sports Medicine

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