Functional Shoulder Evaluation after Osteosynthesis of Greater Tuberosity Fracture: Is There any Influence of Glenohumeral Dislocation?

Guilherme Grisi Mouraria; Renato Mason Rodrigues da Cunha; Sérgio de Paula Coelho; Rafael Mulati Brigatto; Márcio Alves Cruz; Maurício Etchebehere

doi:10.1055/s-0042-1749416

Functional Shoulder Evaluation after Osteosynthesis of Greater Tuberosity Fracture: Is There any Influence of Glenohumeral Dislocation?

Rev Bras Ortop (Sao Paulo). 2022 Jun 6;58(2):265-270. doi: 10.1055/s-0042-1749416. eCollection 2023 Apr.

Authors

Guilherme Grisi Mouraria¹, Renato Mason Rodrigues da Cunha¹, Sérgio de Paula Coelho¹, Rafael Mulati Brigatto², Márcio Alves Cruz³, Maurício Etchebehere¹

Affiliations

¹ Grupo de Ombro e Cotovelo, Departamento de Ortopedia, Reumatologia e Traumatologia, Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
² Hospital Estadual Sumaré, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.
³ Faculdade de Ciências Médicas, Universidade Estadual de Campinas (Unicamp), Campinas, SP, Brasil.

Abstract

Objective To evaluate the postoperative functional and radiographic outcomes of the shoulder of patients submitted to transosseous suturing of a greater tuberosity fracture (GTF) through an anterolateral route and the influence of the glenohumeral dislocation on these outcomes. Methods We conducted a retrospective study and functional assessment using the Constant-Murley score. The distance between the greater tuberosity and the joint surface of the proximal humerus (in true anteroposterior radiographs) after the union was calculated. We used the Fisher exact test for the categorical independent variables, and the Student t or Mann-Whitney test for the non-categorical variables. Results In total, 26 patients met the inclusion criteria, and 38% of the sample presented an association between glenohumeral dislocation and GTF. The mean Constant-Murley score was of 82.5 + 8.02 points. The presence of an associated dislocation did not alter the functional outcome. The mean distance between the greater tuberosity of the humerus and the joint surface of the humeral head after the union was of 9 ± 4.3 mm below the articular line of the humeral head. The dislocation led to a lower level of reduction, but this did not influence the Constant-Murley score. Conclusion The cases of GTF submitted to surgical treatment with transosseous sutures had good functional outcomes. The presence of dislocation made the anatomical reduction of the greater tuberosity difficult. However, it did not influence the Constant-Murley score.

Keywords: humeral fractures; shoulder dislocation; suture anchors; suture techniques.

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