Fractures of the greater and lesser tuberosity of the humerus. Suture anchor fixation

Fractures of the greater and lesser tuberosities of the humerus are often caused by direct trauma or traumatic dislocations. Besides clinical examination and radiological diagnostics, computed tomography (CT) scans and magnetic resonance imaging (MRI) should be obtained. In general, fragment dislocations up to 3 mm are treated non-operatively with repeated radiological control examinations. Operative treatment includes osteosynthesis with plates, screws or suture fixation. This article describes the procedure including arthroscopy and fixation by suture anchors. This technique has several advantages: (1) The tuberosities can be securely fixed even when they are split into several pieces, (2) there is no need for hardware removal in a second procedure, (3) continuous and planar fixation of the fragment to the bone, (4) primary stability allows early functional rehabilitation.