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Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus

Greater tuberosity fractures of the humerus can be successfully

treated nonsurgically in most patients. However, as little as 3 to 5 mm

of superior greater tuberosity displacement may adversely affect

rotator cuff biomechanics and lead to subacromial impingement in

patients who are active. In these cases, surgical treatment is

recommended. Multiple surgical techniques include open and

arthroscopic options tailored to fracture morphology, and strategies for

repair include the use of suture anchors, transosseous sutures,

tension bands, and plates/screws. Three classification systems are

commonly used to describe greater tuberosity fractures: the AO, Neer,

and morphologic classifications. Several hypotheses have been

discussed for the mechanism of greater tuberosity fractures and the

deforming forces of the rotator cuff, and the use of advanced imaging

is being explored.