Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 5 , Pages 600-609 , May 2010

Arthroscopic Fixation Technique for Comminuted, Displaced Greater Tuberosity Fracture

  • Jong-Hun Ji, M.D.

      Affiliations

    • Department of Orthopedic Surgery, College of Medicine, The Catholic University, Daejeon St Mary's Hospital, Daejeon, South Korea
  • ,
  • Mohamed Shafi, M.S.(Ortho)

      Affiliations

    • Department of Orthopedic Surgery, College of Medicine, The Catholic University, Daejeon St Mary's Hospital, Daejeon, South Korea
  • ,
  • In-Soo Song, M.D.

      Affiliations

    • Sun Hospital, Daejeon, South Korea
  • ,
  • Young-Yul Kim, M.D.

      Affiliations

    • Department of Orthopedic Surgery, College of Medicine, The Catholic University, Daejeon St Mary's Hospital, Daejeon, South Korea
  • ,
  • Edward G. McFarland, M.D.

      Affiliations

    • Johns Hopkins University, Baltimore, Maryland, U.S.A.
  • ,
  • Chang-Yun Moon, M.D.

      Affiliations

    • Department of Orthopedic Surgery, College of Medicine, The Catholic University, Daejeon St Mary's Hospital, Daejeon, South Korea
    • Corresponding Author InformationAddress correspondence and reprint requests to Chang-Yun Moon, M.D., Department of Orthopedic Surgery, Daejon St Mary's Hospital, The Catholic University of Korea, 520-2, Deahung-dong, Joong-ku, Daejon 302-803, South Korea

Received 15 January 2009 ,Accepted 10 September 2009.

References 

  1. Kristiansen B, Barfod G, Bredesen J, et al. Epidemiology of proximal humeral fractures. Acta Orthop Scand. 1987;58:75–77
  2. Bahrs C, Lingenfelter E, Fischer F, Walters EM, Schnabel M. Mechanism of injury and morphology of the greater tuberosity fracture. J Shoulder Elbow Surg. 2006;15:140–147
  3. Lind T, Kroner K, Jensen J. The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg. 1989;108:285–287
  4. Rowe CR. Prognosis in dislocations of the shoulder. J Bone Joint Surg Am. 1956;38:957–977
  5. Kim E, Shin HK, Kim CH. Characteristics of an isolated greater tuberosity fracture of the humerus. J Orthop Sci. 2005;10:441–444
  6. Flatow EL, Cuomo F, Maday MG, Miller SR, McIlveen SJ, Bigliani LU. Open reduction and internal fixation of two-part displaced fractures of the greater tuberosity of the proximal part of the humerus. J Bone Joint Surg Am. 1991;73:1213–1218
  7. Herscovici D, Saunders DT, Johnson MP, Sanders R, DiPasquale T. Percutaneous fixation of proximal humeral fractures. Clin Orthop Relat Res. 2000;97–104
  8. Bonsell S, Buford DA. Arthroscopic reduction and internal fixation of a greater tuberosity fracture of the shoulder: A case report. J Shoulder Elbow Surg. 2003;12:397–400
  9. Taverna E, Sansone V, Battistella F. Arthroscopic treatment for greater tuberosity fractures: Rationale and surgical technique. Arthroscopy. 2004;20:e53–e57www.arthroscopyjournal.org
  10. Brady PC, Arrigoni P, Burkhart SS. Evaluation of residual rotator cuff defects after in vivo single-versus double-row rotator cuff repairs. Arthroscopy. 2006;22:1070–1075
  11. Cummins CA, Appleyard RC, Strickland S, Haen PS, Chen S, Murrell GA. Rotator cuff repair: An ex vivo analysis of suture anchor repair techniques on initial load to failure. Arthroscopy. 2005;21:1236–1241
  12. Kim DH, Elattrache NS, Tibone JE, et al. Biomechanical comparison of a single-row versus double-row suture anchor technique for rotator cuff repair. Am J Sports Med. 2006;34:407–414
  13. Lo IK, Burkhart SS. Double-row arthroscopic rotator cuff repair: Re-establishing the footprint of the rotator cuff. Arthroscopy. 2003;19:1035–1042
  14. Mazzocca AD, Millett PJ, Guanche CA, Santangelo SA, Arciero RA. Arthroscopic single-row versus double-row suture anchor rotator cuff repair. Am J Sports Med. 2005;33:1861–1868
  15. Meier SW, Meier JD. The effect of double-row fixation on initial repair strength in rotator cuff repair: A biomechanical study. Arthroscopy. 2006;22:1168–1173
  16. Park MC, Cadet ER, Levine WN, Bigliani LU, Ahmad CS. Tendon-to-bone pressure distributions at a repaired rotator cuff footprint using transosseous suture and suture anchor fixation techniques. Am J Sports Med. 2005;33:1154–1159
  17. Tuoheti Y, Itoi E, Yamamoto N, et al. Contact area, contact pressure, and pressure patterns of the tendon-bone interface after rotator cuff repair. Am J Sports Med. 2005;33:1869–1874
  18. Bhatia DN, van Rooyen KS, du Toit DF, de Beer JF. Surgical treatment of comminuted, displaced fractures of the greater tuberosity of the proximal humerus: A new technique of double-row suture-anchor fixation and long-term results. Injury. 2006;37:946–952
  19. Ji JH, Kim WY, Ra KH. Arthroscopic double-row suture anchor fixation of minimally displaced greater tuberosity fractures. Arthroscopy. 2007;23:1133.e1–1133.e4www.arthroscopyjournal.org
  20. Song HS, Williams GR. Arthroscopic reduction and fixation with suture-bridge technique for displaced or comminuted greater tuberosity fractures. Arthroscopy. 2008;24:956–960
  21. Kim KC, Rhee KJ, Shin HD, Kim YM. Arthroscopic fixation for displaced greater tuberosity fracture using the suture-bridge technique. Arthroscopy. 2008;24:120.e1–120.e3www.arthroscopyjournal.org
  22. Kim SH, Ha KI, Ahn JH, Park JH. Differential arthroscopic portal placement for rotator cuff repair. Arthroscopy. 2002;18:43e
  23. Jurik AG, Albrechtsen J. The use of computed tomography with two- and three-dimensional reconstructions in the diagnosis of three- and four-part fractures of the proximal humerus. Clin Radiol. 1994;49:800–804
  24. Platzer P, Kutscha-Lissberg F, Lehr S, Vecsei V, Gaebler C. The influence of displacement on shoulder function in patients with minimally displaced fractures of the greater tuberosity. Injury. 2005;36:1185–1189
  25. Platzer P, Thalhammer G, Oberleitner G, et al. Displaced fractures of the greater tuberosity: A comparison of operative and nonoperative treatment. J Trauma. 2008;65:843–848
  26. Neer CS. Displaced proximal humeral fractures (I. Classification and evaluation). J Bone Joint Surg Am. 1970;52:1077–1089
  27. Bigliani LU, Pollock RG. The shoulder. Philadelphia: WB Saunders; 1998;
  28. Park TS, Choi IY, Kim YH, Park MR, Shon JH, Kim SI. A new suggestion for the treatment of minimally displaced fractures of the greater tuberosity of the proximal humerus. Bull Hosp Jt Dis. 1997;56:171–176
  29. Kim SH, Ha KI. Arthroscopic treatment of symptomatic shoulders with minimally displaced greater tuberosity fracture. Arthroscopy. 2000;16:695–700
  30. Green A, Izzi J. Isolated fractures of the greater tuberosity of the proximal humerus. J Shoulder Elbow Surg. 2003;12:641–649
  31. Park MC, Murthi AM, Roth NS, Blaine TA, Levine WN, Bigliani LU. Two-part and three-part fractures of the proximal humerus treated with suture fixation. J Orthop Trauma. 2003;17:319–325

 The authors report no conflict of interest.

PII: S0749-8063(09)00796-8

doi: 10.1016/j.arthro.2009.09.011

Arthroscopy: The Journal of Arthroscopic and Related Surgery
Volume 26, Issue 5 , Pages 600-609 , May 2010