Comparative Study Between Operative and Conservative Treatment of Un-Displaced Isolated Greater Tuberosity Fracture of The Humerus

Abstract

Background: 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 open reduction and internal fixation (ORIF) using plate and screws, fragment excision, and percutaneous fixation.Aim of the Work: This study aims to compare between the operative and conservative treatment of un-displaced isolated greater tuberosity fracture of the humerusPatients and Methods: We performed a prospective interventional study involved 20 patients with isolated greater tuberosity fractures. Divided equally into 10 patients in each group (conservative group and operative group). Radiographic healing was evaluated in the follow-up images. For the objective evaluation, the DASH score was used.Results: The mean age in conservative group was 37.7 years and in operative was 36.9 years. Male patients represented 60% and 70% within conservative and operative groups respectively. Four patient (40%) had anterior shoulder dislocation within operative group. The two groups were not different statistically regarding range of motion. The median DASH score of operative group 13.49, while it was 20.83 within the 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 enhances early union.

Keywords

• greater tuberosity
• fractures
• humerus
• dash score