Screws versus plate fixation of isolated greater tuberosity humeral fracture through the transdeltoid approach
Mohamed A. Negm, Mahmoud A. Eldeghaidy, Sameh A. El Sayed AbdelaalBackground and aim
Anterior shoulder dislocation or impaction injury against the acromion or superior glenoid may result in isolated fractures of the greater tuberosity of the humerus. Greater tuberosity fractures may be associated with labral tears and partial-thickness rotator cuff tears, which can result in chronic pain following fracture recovery. The study aimed to compare the use the radiological and functional results of plates versus screw fixation in the treatment of isolated greater tuberosity humeral fractures.
Patients and methods
This prospective cohort study included 30 patients with isolated greater tuberosity fractures of the humerus, who presented to the emergency room or the outpatient clinic of Al Azhar University (Al-Hussien and El-Sayed Galal Hospital) in addition to the outpatient clinic of Om Elmasrein Hospital. The study was conducted from July 2022 to May 2023.
Results
Our findings indicate that there was no statistically significant variation in clinical outcomes based on the degree of fragment displacement when considering the mean Disabilities of the Arm, Shoulder, and Hand score 6 months later. During the first 8 weeks, plate fixation demonstrated significantly greater improvement than screw fixation.
Conclusion
Rarely, complications like nonunion and subacromial impingement syndrome develop. Infection occurred in a few patients because of poor hygiene and untreated wounds; however, other complications, such as intraoperative complications, secondary displacement, and implant loosening, did not occur. In this paper, we present a technique for fixing isolated greater tuberosity fractures using a distal radius T-plate. Consequently, we think it can be a useful tool for the surgeon to use while treating these injuries.