Acta Scientific Orthopaedics (ISSN: 2581-8635)

Research Article Volume 6 Issue 4

Comparative Study between Operative and Conservative Treatment of Un-Displaced Isolated Greater Tuberosity Fracture of the Humerus

TA Al-Sadek1* and AAl-Sadek2

1Trakia University, Medical college - Stara Zagora, Bulgatria
2UMHAT Tsaritsa Joanna- ISUL, Department of Orthopedics and Traumatology- Sofia, Bulgaria

*Corresponding Author: TA Al-Sadek, Trakia University, Medical college - Stara Zagora, Bulgatria.

Received: February 20, 2023; Published: March 27, 2023

Abstract

Background and Purpose: Fractures of the greater tuberosity of humerus account for one fifth of all fractures affecting the proximal ⅓ of humerus. Although a displacement of 3-5 mm in fractured greater tuberosity indicates surgical intervention, less displaced tuberosities can be managed nonoperatively in young athletes as well as more displacement in older groups. Surgical modalities include ORIF using plate and screws, fragment excision, and percutaneous fixation.

Patients and Methods: We performed a prospective interventional study involved 20 patients with isolated greater tuberosity fractures of the humerus. Divided equally into 10 in each group, conservative and operative management. The follow-up images were assessed for radiographic healing. For the objective assessment, the DASH score was used.

Results: We have twenty patients with un-displaced isolated greater tuberosity fracture; divided equally into ten in each group; conservative and operative. The mean age in conservative group 37.7 and in operative 36.9 with statistically non-significant difference. Male patients represented 60% and 70% within conservative and operative groups respectively. There is statistically non-significant difference between studied groups regarding range of motion. Four patient (40%) had anterior shoulder dislocation within operative group. The median DASH score of operative group 13.49, while it was 20.83 within conservative group.

Conclusion: Un-displaced greater tuberosity fractures can be treated without surgery with good outcome; however there are indications for surgical interventional with benefit of provides early return to life activity as it enhance early union.

Keywords: Greater Tuberosity; Fractures; Humerus

References

  1. Fakler JK., et al. “Current concepts in the treatment of proximal humeral fractures”. Orthopedics 1 (2008): 42-51.
  2. George MS. “Fractures of the greater tuberosity of the humerus”. Journal of the American Academy of Orthopaedic Surgeons 10 (2007): 607-613.
  3. Hebert-Davies J., et al. “Delayed migration of greater tuberosity fractures associated with anterior shoulder dislocation”. Journal of Orthopaedic Trauma 10 (2015): e396-e400.
  4. Volpin G., et al. “Impingement syndrome following direct injuries of the shoulder joint”. Harefuah4 (1996): 244-247.
  5. Bogdan Y., et al. “An alternative technique for greater tuberosity fractures: use of the mesh plate”. Archives of Orthopaedic and Trauma Surgery 137 (2017): 1067-1070.
  6. Lizzio VA., et al. “Clinical evaluation and physical exam findings in patients with anterior shoulder instability”. Current Reviews in Musculoskeletal Medicine 10 (2017): 434-441.
  7. Anon MG., et al. “Operative repair of proximal humerus fractures in septuagenarians and octogenarians: Does chronologic age matter?” Journal of Clinical Orthopaedics and Trauma 1 (2017): 50-53.
  8. Anon EA., et al. “Isolated greater tuberosity fractures of the proximal humerus: anatomy, injury patterns, multimodality imaging, and approach to management”. Emergency Radiology 3 (2018): 235-246.
  9. Darweash A and Abou Ouf A. “Hybrid fixation of late presenting greater tuberosity fracture following shoulder dislocation”. The Egyptian Orthopedic Journal 55 (2020): 1-6.
  10. Schliemann B., et al. “Isolated fractures of the greater tuberosity: When are they treated conservatively?” Obere Extremität 13 (2018): 106-111.
  11. Bh B., et al. “Osteotomy and re-fixation for treatment of malunited greater tuberosity of humerus”. Journal of Orthopaedic Case Reports 1 (2012): 18-20.
  12. Wilcox III RB., et al. “Management of a patient with an isolated greater tuberosity fracture and rotator cuff tear”. Journal of Orthopaedic and Sports Physical Therapy8 (2005): 521-530.
  13. Gruson KI., et al. “Isolated tuberosity fractures of the proximal humeral: current concepts”. Injury3 (2008): 284-298.
  14. Neer CS. “The classic: displaced proximal humeral fractures: part i. classification and evaluation”. Clinical Orthopaedics and Related Research® 442 (2006): 77-82.
  15. Helfen SR., et al. “Outcomes of surgical fixation of greater tuberosity fractures: A systematic review”. Orthopaedics and Traumatology: Surgery and Research 6 (2020): 1119-1126.
  16. Patel AH., et al. “How age and gender influence proximal humerus fracture management in patients older than fifty years”. JSES International2 (2022): 253-258.

Citation

Citation: TA Al-Sadek and AAl-Sadek. “Comparative Study between Operative and Conservative Treatment of Un-Displaced Isolated Greater Tuberosity Fracture of the Humerus”.Acta Scientific Orthopaedics 6.4 (2023): 70-75.

Copyright

Copyright: © 2023 TA Al-Sadek and AAl-Sadek. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




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