Samuel R Huntley1, Eva J Lehtonen1, Joseph Xavier Robin1, Alexandra M Arguello1, Dominique M Rouleau2, Eugene W Brabston1, Brent A Ponce1, Amit M Momaya3. 1. University of Alabama at Birmingham, Birmingham, AL, United States. 2. Faculty of Medicine, université de Montréal, 2900, boulevard Edouard-Montpetit, H3T 1J4 Montréal, QC, Canada; Hôpital du Sacré-Cœur, C2095-5400, boulevard Gouin O., H4J 1C5 Montréal, QC, Canada. 3. University of Alabama at Birmingham, Birmingham, AL, United States. Electronic address: amit.momaya@gmail.com.
Abstract
BACKGROUND: Isolated greater tuberosity fractures account for up to a fifth of all proximal humeral fractures. There have been several retrospective cohort studies and case series reporting outcomes after treatment of this pathology. This study aims to report on the clinical outcomes of surgically treated isolated greater tuberosity fractures, as well as diagnostic workup and complications associated with fracture fixation. METHODS: A systematic review was performed under PRISMA guidelines to identify studies that reported the results or clinical outcomes of isolated greater tuberosity fracture. The searches were performed using MEDLINE through PubMed, the Elsevier Embase database, and the Cochrane Database of Systematic Reviews. RESULTS: Sixteen studies met inclusion criteria comprising 345 patients and 345 shoulders. The mean age was 52.9 years and mean follow-up was 3.4 months. The mean postoperative American Shoulder and Elbow Surgeon Score, the most frequently utilized patient reported outcome measure across studies, was 90.1% of ideal maximum. All studies used standard shoulder radiographs in their initial workup and most commonly referred to a minimum of 5mm displacement as an indication for surgery. Fifty five percent of patients were treated using open fixation and 35.9 with arthroscopic fixation. Ninety three percent of patients were able to return to work. A total of fifty-two (15.1%) complications were reported in the included studies. CONCLUSIONS: The current literature describes overall satisfactory functional outcomes and minimal occupational morbidity following either open or arthroscopic fixation of isolated greater tuberosity fractures despite a notable rate of complications. LEVEL OF EVIDENCE: IV, systematic review.
BACKGROUND: Isolated greater tuberosity fractures account for up to a fifth of all proximal humeral fractures. There have been several retrospective cohort studies and case series reporting outcomes after treatment of this pathology. This study aims to report on the clinical outcomes of surgically treated isolated greater tuberosity fractures, as well as diagnostic workup and complications associated with fracture fixation. METHODS: A systematic review was performed under PRISMA guidelines to identify studies that reported the results or clinical outcomes of isolated greater tuberosity fracture. The searches were performed using MEDLINE through PubMed, the Elsevier Embase database, and the Cochrane Database of Systematic Reviews. RESULTS: Sixteen studies met inclusion criteria comprising 345 patients and 345 shoulders. The mean age was 52.9 years and mean follow-up was 3.4 months. The mean postoperative American Shoulder and Elbow Surgeon Score, the most frequently utilized patient reported outcome measure across studies, was 90.1% of ideal maximum. All studies used standard shoulder radiographs in their initial workup and most commonly referred to a minimum of 5mm displacement as an indication for surgery. Fifty five percent of patients were treated using open fixation and 35.9 with arthroscopic fixation. Ninety three percent of patients were able to return to work. A total of fifty-two (15.1%) complications were reported in the included studies. CONCLUSIONS: The current literature describes overall satisfactory functional outcomes and minimal occupational morbidity following either open or arthroscopic fixation of isolated greater tuberosity fractures despite a notable rate of complications. LEVEL OF EVIDENCE: IV, systematic review.
Authors: Dylan R Rakowski; Joseph J Ruzbarsky; Thomas E Woolson; Marilee P Horan; Philip-C Nolte; Peter J Millett Journal: Arthrosc Sports Med Rehabil Date: 2022-02-23