Arthroscopic Management of Displaced Greater Tuberosity Fractures
Displaced greater tuberosity fractures of the humerus require anatomic reduction with stable fixation to optimize rotator cuff function and prevent subacromial impingement. A wide variety of surgical approaches and fixation constructs have been reported, largely with favorable results. Arthroscopic...
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| Published in: | Arthroscopy techniques (Amsterdam) Vol. 10; no. 4; pp. e1055 - e1060 |
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01-04-2021
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| Abstract | Displaced greater tuberosity fractures of the humerus require anatomic reduction with stable fixation to optimize rotator cuff function and prevent subacromial impingement. A wide variety of surgical approaches and fixation constructs have been reported, largely with favorable results. Arthroscopic management of these fractures allows excellent visualization with strong suture anchor fixation while minimizing soft tissue disruption, blood loss, and radiation exposure. The purpose of this article is to describe an arthroscopic technique for reduction and suture-anchor fixation of displaced greater tuberosity fractures.
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| AbstractList | Displaced greater tuberosity fractures of the humerus require anatomic reduction with stable fixation to optimize rotator cuff function and prevent subacromial impingement. A wide variety of surgical approaches and fixation constructs have been reported, largely with favorable results. Arthroscopic management of these fractures allows excellent visualization with strong suture anchor fixation while minimizing soft tissue disruption, blood loss, and radiation exposure. The purpose of this article is to describe an arthroscopic technique for reduction and suture-anchor fixation of displaced greater tuberosity fractures.
Video 1
Narrated video of arthroscopic greater tuberosity fracture fixation in 2 patients. The first case demonstrates the classic posteromedial displacement of this fracture pattern from the pull of the infraspinatus tendon. An anterolateral suture anchor placed well away from the fracture bed is used to correct this displacement. The second case demonstrates superomedial displacement of the fracture fragment. Provisional reduction is performed with a spinal needle, which helps guide the position of the anchor. Anchor placement at the margin of the fracture site is demonstrated, with care to gain appropriate purchase of the anchor with precise starting position and trajectory. Retrograde suture passage in a horizontal mattress pattern is shown. Tensioning and later tying the sutures facilitates anatomic reduction, which can be confirmed from subacromial and glenohumeral views. Note the restoration of rotator cuff position just medial to the fracture site in each view. Displaced greater tuberosity fractures of the humerus require anatomic reduction with stable fixation to optimize rotator cuff function and prevent subacromial impingement. A wide variety of surgical approaches and fixation constructs have been reported, largely with favorable results. Arthroscopic management of these fractures allows excellent visualization with strong suture anchor fixation while minimizing soft tissue disruption, blood loss, and radiation exposure. The purpose of this article is to describe an arthroscopic technique for reduction and suture-anchor fixation of displaced greater tuberosity fractures. Displaced greater tuberosity fractures of the humerus require anatomic reduction with stable fixation to optimize rotator cuff function and prevent subacromial impingement. A wide variety of surgical approaches and fixation constructs have been reported, largely with favorable results. Arthroscopic management of these fractures allows excellent visualization with strong suture anchor fixation while minimizing soft tissue disruption, blood loss, and radiation exposure. The purpose of this article is to describe an arthroscopic technique for reduction and suture-anchor fixation of displaced greater tuberosity fractures. [Display omitted] |
| Author | Holt, Andrew M. Field, Larry D. |
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| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/33981550$$D View this record in MEDLINE/PubMed |
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| Cites_doi | 10.1016/j.arthro.2007.05.003 10.1016/j.injury.2005.02.018 10.1016/j.arthro.2006.11.029 10.1002/jor.21530 10.1186/s12891-017-1868-7 10.5435/JAAOS-D-14-00289 10.1016/j.ocl.2013.12.007 10.3928/01477447-20120525-17 10.1016/j.eats.2019.05.007 10.1016/j.eats.2017.02.006 10.1007/BF00932316 10.1007/s11999-015-4663-5 10.1053/jars.2000.9237 10.1080/000164701753542023 10.1016/j.jse.2017.11.029 |
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| Title | Arthroscopic Management of Displaced Greater Tuberosity Fractures |
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