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

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

doi:10.1055/s-0042-1749417

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Original Article • Rev. bras. ortop. 58 (2) • Mar-Apr 2023 • https://doi.org/10.1055/s-0042-1749417 copy

Functional Shoulder Evaluation after Osteosynthesis of Greater Tuberosity Fracture: Is There any Influence of Glenohumeral Dislocation?^* * Study developed at the Department of Orthopedics, Rheumatology and Traumatology, Faculty of Medical Sciences, Campinas State University (UNICAMP), Campinas, São Paulo-SP, Brazil.

Authorship SCIMAGO INSTITUTIONS RANKINGS

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

		Dislocation
	Total (n)	No – n (%)	Yes – n (%)	p-value
Gender
Male	20	10 (50%)	10 (50%)	0.05^a
Female	06	6 (100%)	0 (0.0%)
Age (years)
Mean ± standard deviation		41.1 ± 15.3	42.5 ± 12.4	0.73^b
Comorbidities
Yes	11	6 (54.5%)	5 (45.5%)	0.68^a
No	15	10 (66.6%)	5 (33.3%)
Affected side
Dominant	19	14 (73.7%)	5 (26.3.%)	0.69^a
Non-dominant	07	2 (28.6%)	5 (71.4%)

	Dislocation
	No	Yes	p-value
Constant-Murley score: median (minimum-maximum)	83.0 (72-95)	84.0 (78-92)	0.63^c
Distance (mm) from the apex of the great tuberosity to the joint surface: median (minimum-maximum)	6.92 (2-13)	9.98 (7-16)	0.01^c

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E-mail: rbo@sbot.org.br

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[1] Address for correspondence Guilherme Grisi Mouraria, PhD, Orthopedics, Rheumatology and Traumatology, Faculty of Medical Sciences, Campinas State University, Tessália Vieira de Camargo Street , 126, Campinas, SP, Brazil (e-mail: mouraria@unicamp.br).