SLAP tear associated with a minimally displaced proximal humerus fracture.

Nondisplaced proximal humerus fracture may be associated with soft tissue injury. This case report examines 2 cases of superior labral anterior-posterior (SLAP) tears in association with nondisplaced fractures of the proximal humerus. In the first case, the patient fell from a jet ski, causing a traction injury to his arm. A greater tuberosity fracture was identified. Magnetic resonance imaging (MRI) did not reveal a definitive labral tear. After conservative management had failed, a type IV SLAP tear and a small rotator cuff tear were arthroscopically identified and repaired. In the second case, a power company lineman fell from a lift and attempted to hold on with his dominant arm. A nondisplaced greater tuberosity and a surgical neck fracture were discovered. MR arthrography revealed no evidence of SLAP tear. Four months after injury, a type II SLAP tear was arthroscopically identified and repaired. In these 2 cases, the presence of the fracture likely slowed operative intervention because pain was attributed to the fracture itself, and not to the SLAP tear. If patients do not follow the usual course of improvement after a proximal humerus fracture from a superior traction mechanism, consideration should be given to associated superior labral tears that may require surgical intervention.