Fractures of the greater tuberosity of the humerus

Isolated fractures of the greater tuberosity of the humerus can occur in anterior shoulder dislocations or as the result of an impaction injury against the acromion or superior glenoid. Greater tuberosity fractures may be associated with partial-thickness rotator cuff tears and labral tears, which may be the cause of persistent pain after fracture healing. Nondisplaced and minimally displaced fractures are typically treated successfully nonsurgically. Surgical fixation is recommended for fractures with > 5 mm of displacement in the general population or > 3 mm of displacement in active patients involved in frequent overhead activity. Open surgical repair is performed with suture or screw fixation. Recently, arthroscopic techniques have produced promising results. Careful follow-up and supervised rehabilitation optimize results after both nonsurgical and surgical treatment.