Tuberosity fractures

Abstract

In this chapter, we discuss fractures of the tuberosities, but one must keep in mind that bony injuries are soft tissue injuries surrounding a radiographic fracture. The soft tissue juxtaposed against the fracture helps guide our treatment of that particular fracture and should be treated with the tendon and related function in mind. This consideration helps focus the diagnostic and therapeutic interventions related to the rotator cuff and its concomitant bony injury or, in this case, a tuberosity fracture. Considering the mechanism of injury surrounding tuberosity fractures as either high-energy impingement injuries against the acromion, coracoid, or glenoid rim also helps treating surgeons focus on associated soft tissue trauma that should be considered. Operative indications for greater tuberosity fractures include fracture displacement greater than 5Â mm or greater than 3Â mm of displacement in athletes or in patients performing frequent occupational or recreational overhead activities, whereas the threshold for lesser tuberosity fracture-displacement is less. In this chapter, we also review the most current surgical techniques to include open reduction and internal fixation and arthroscopic reduction and internal fixation.