Surgical management of isolated greater tuberosity fractures of the proximal humerus.

Because the greater tuberosity is the insertion site of the posterior superior rotator cuff, fractures can have a substantial impact on functional outcome. Isolated fractures should not inadvertently be trivialized. Thorough patient evaluation is required to make an appropriate treatment decision. In most cases surgical management is considered when there is displacement of 5 mm or greater. Although reduction of displaced greater tuberosity fractures has traditionally been performed with open techniques, arthroscopic techniques are now available. The most reliable techniques of fixation of the greater tuberosity incorporate the rotator cuff tendon bone junction rather than direct bone-to-bone fixation.