Arthroscopic Treatment for a Chronic Isolated Avulsion Fracture of the Lesser Tuberosity of the Humerus: A Case Report

The patient was a 47-year-old man who worked as a sales representative.He presented with a history of falling down stairs two years previously, at which time he sustained trauma to the right shoulder.Since then, he had experienced pain and functional impairment, which he described as being unable to perform intimate hygiene or grab a wallet from his back trouser pocket and difficulty in using his arm when above shoulder height.The patient did not seek medical assistance at the time of the trauma because he did not have medical insurance and did not want to be treated in the public healthcare sector.Our initial physical examination showed a normal but painful range of movement; with positive tests for evaluate subscapularis tendon injury (e.g., bear-hug, Gerber, abdominal compression and liftoff tests).His DASH (Disabilities of the Arm, Shoulder and Hand) score was 60, his UCLA (University of California at Los Angeles) Shoulder Score was 16, his SF-36 (Short Form Health Survey) Score was 32.7 and his visual analog scale (VAS) score was 10.Shoulder x-rays revealed an avulsion fracture of the lesser tuberosity of the proximal humerus (Figure 1).Magnetic resonance imaging was done to support this, which confirmed the diagnosis of an isolated displaced fracture of the lesser tuberosity (Figure 2).