Management of Greater Tuberosity Fractures

The appropriate management of greater tuberosity fractures of the humerus is dependent on the knowledge of relevant anatomy, injury epidemiology, fracture pattern and, importantly, an understanding of the injured patient. Most fractures are nondisplaced and can be treated nonoperatively, following a multiphasic protocol. In general, displacement measuring 5 mm or more is recommended for surgery. Surgery may be performed arthroscopically, percutaneously, with open reduction and internal fixation, or a combination of the aforementioned. Several factors such as surgeon experience, preference, chronicity, size, and comminution of the fracture play a role in determining the proper technique. Regardless of surgical technique, surgical repair should include fixation utilizing the strength of the rotator cuff when possible.