Arthroscopic treatment of symptomatic shoulders with minimally displaced greater tuberosity fracture.

PURPOSE: The purpose of this study is to describe arthroscopic findings and the results of arthroscopic treatment of patients with chronic shoulder pain caused by a minimally displaced fracture of the greater tuberosity.

TYPE OF STUDY: This is a retrospective case series in a consecutive sample of 23 patients with a minimally displaced or nondisplaced fracture of the greater tuberosity who underwent outcome analysis after arthroscopic treatment.

MATERIALS AND METHODS: Twenty-three patients with chronic shoulder pain beyond 6 months after fracture of the greater tuberosity underwent arthroscopic treatment and were retrospectively assessed after an average of 29 months (range, 22 to 40 months). There were 18 men and 5 women with the average age of 39 years (range, 24 to 61 years). Fourteen fractures were isolated and 9 were related to acute anterior instability episode. The average displacement of the fracture was 2.3 mm (range, 0 to 4 mm) as shown on anteroposterior view plain radiographs.

RESULTS: At the time of arthroscopy, all patients had partial-thickness rotator cuff tears on the articular surface. The cuff tears were located on the tuberosity fracture area and were an Ellman grade I to II in depth. After arthroscopic debridement or repair of the tear, depending on the condition of the tear itself, as well as subacromial decompression, the UCLA score results were good to excellent in 20 and fair in 3 patients. Nineteen of the patients had returned to the previous level of activities. However, the patients engaged in overhead sports activity had a lower level of return to activity (P =.034).

CONCLUSIONS: A partial-thickness rotator cuff tear on the articular surface should be considered in patients with chronic shoulder pain after a minimally displaced fracture of the greater tuberosity. Arthroscopic debridement or repair is an appropriate procedure.