• The Academic Congress of Korean Shoulder and Elbow Society
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• 2009.03a
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• pp.200-201
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• 2009

• Clinics in Shoulder and Elbow
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• v.2 no.1
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• pp.21-27
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• 1999

Purpose : The purpose of this study was to evaluate the functional outcomes of one-part fracture of the greater tuberosity that had been treated either by a conservative treatment or an operative approach. Materials and Method: Eighteen shoulders in 18 patients who had an one-part fracture of the greater tuberosity of the proximal humerus were managed, and the average follow-up period was 4 years and 10 months (range, 1 year to 8 years 6 months). Results: According to Neer's criteria for evaluation of results, in the group of 13 patients managed nonoperatively, the results were good or excellent in ten patients, fair in one, and poor in two. In the group managed operatively, the results were excellent in all five patients. Conclusion: If the displacement of the fragment is more than 5mm in young active patients, and more than 3mm especially in athletes and heavy laborers involved in overhead activity, the fragment should be mobilized, repaired and fixed into its original bed or a little bit inferolaterally with multiple heavy non-absorbable sutures, tension band technique, or cancellous screws and washers. We would suggest that the patients showing one-part fracture of the greater tuberosity of the proximal humerus should be evaluated individually.

• Clinics in Shoulder and Elbow
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• v.10 no.2
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• pp.227-231
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• 2007

A posterior shoulder dislocation with a fracture is rare. Most fractures are impression fractures of the humeral head or lesser tuberosity fractures. However, there are no reports of a complete rupture of the rotator cuff with a combined posterior glenohumeral dislocation. We report a unique case of a posterior shoulder dislocation with an avulsion fracture of the greater tuberosity and a complete rupture of infraspinatus, teres minor and subscapularis tendons, which were treated surgically.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.195-200
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• 2017

Background: This study investigated and evaluated the clinical outcomes of intra-articular lesions of traumatic anterior shoulder dislocation (TASD) associated with greater tuberosity (GT) fracture of the humerus. Methods: Subjects included 20 patients who were surgically or non-surgically treated for GT fracture of the humeurs with TASD, and followed-up for at least 2 years. The mean follow-up period was 54.1 months (range, 24-105 months). Of the 20 patients, 12 were treated surgically. Intra-articular lesions were identified randomly on magnetic resonance imaging scans (repeated thrice) by experienced radiologists and orthopedic surgeons. The accompanying intra-articular lesions were left untreated. Clinical outcomes were evaluated by Simple Shoulder Test (SST) and Western Ontario Shoulder Instability index (WOSI) at the last follow-up. Results: Intra-articular lesions were identified in 19 patients: 7 Bankart lesions, 15 humeral avulsion of the glenohumeral ligament lesions, 3 glenoid avulsion of the glenohumeral ligament lesion, and 6 inferior capsular tears. Two or more intra-articular lesions were identified in 6 patients. The mean SST score was 10.9 and the mean WOSI score was 449.3 at the last follow-up. Conclusions: For GT fracture of the humerus with TASD, a high frequency of diverse intra-articular lesions was identified. There were no incidence of recurrent shoulder dislocations, and good clinical outcomes were obtained without treatment of the intra-articular lesions. We thereby comprehend that although intra-articular lesions may occur in TASD associated with GT fracture of the humeurs, merely treating the GT fracture of the humerus is sufficient.

• Clinics in Shoulder and Elbow
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• v.24 no.4
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• pp.265-271
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• 2021

Four patients with shoulder problems that were traumatic in etiology presented to us with delays in seeking care ranging from 6 to 12 weeks due to the coronavirus disease 2019 (COVID-19) lockdown. The care of three cases (a 3-month-old neglected anterior shoulder dislocation with a greater tuberosity fracture in a 30-year old man, a 3-month-old neglected anterior shoulder dislocation in a 17-year old boy, and a 2-month-old neglected greater tuberosity fracture in a 31-year old man) was delayed due to the lockdown and the ensuing travel restrictions, while that of one case (a 6-week-old fracture-dislocation of the proximal humerus in a 55-year-old woman) was delayed because the patient was undergoing treatment for COVID-19 at the time of injury. This report intends to present the exceptional circumstances around these cases. The unique treatment challenges and their outcomes are also described to advise the surgeons of the nuances and difficulties in treating these injuries.

• Korean Journal of Veterinary Research
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• v.63 no.3
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• pp.24.1-24.6
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• 2023

This study compared the biomechanical properties of bone-stapling techniques with those of other fixation methods used for stabilizing tibial tuberosity fractures using 3-dimensionally (3D)-printed canine bone models. Twenty-eight 3D-printed bone models made from computed tomography scan files were used. Tibial tuberosity fractures were simulated using osteotomy. All samples were divided into 4 groups. Group 1 was stabilized with a pin and tension-band wire; group 2, with a pin and an 8 mm-wide bone staple; group 3, with 2 horizontally aligned pins and an 8 mm-wide bone staple; and group 4 with a 10 mm-wide bone staple. Tensile force was applied with vertical distraction until failure occurred. The load and displacement were recorded during the tests. The groups were compared based on the load required to cause displacements of 1, 2, and 3 mm. The maximum failure loads and modes were recorded. The loads at all displacements in group 4 were greater than those in groups 1, 2, and 3. The loads at 1, 2, and 3 mm displacements were similar in groups 1 and 3. There was no significant difference between groups 1 and 3. Groups 1 and 4 provided greater maximum failure loads than groups 2 and 3. Failure occurred because of tearing of the nylon rope, tibial fracture, wire breakage, pin bending, and fracture around the bone staple insertion. In conclusion, these results demonstrate that the bone-stapling technique is an acceptable alternative to tension-band wire fixation for the stabilization of tibial tuberosity fractures in canine bone models.

• Clinics in Shoulder and Elbow
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• v.2 no.2
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• pp.178-186
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• 1999

Twenty-three patients with chronic shoulder pain beyond 6 months after the 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 were isolated fractures and nine were related to acute anterior instability episode. The average displacement of the fracture was 2.3mm(range, 0 to 4mm) on the anteroposterior view of the plane radiographs. At the time of arthroscopy, all patients had partial thickness rotator cuff tears in the articular surface. The cuff tears were located on the tuberosity fracture area and were an Ellman's grade I to n in depth. With the arthroscopic debridement or repair of the tear depending on the condition of the tear itself, as well as the subacromial decompression, the UCLA score revealed good to excellent results in 20 and fair in 3 patients. Nineteen of the patients had returned to the previous level of activities. The patient with a higher activity demand revealed a lower level of activity return(p=0.034). The partial thickness rotator cuff tear should be considered in patients with chronic shoulder pain after the minimally displaced fracture of the greater tuberosity, and arthroscopic debridement or repair is an appropriate procedure.

• Journal of Korean Orthopaedic Sports Medicine
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• v.6 no.1
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• pp.57-65
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• 2007

Purpose: The purpose of this study was to evaluate the clinical result of arthroscopic treatments by using suture anchors or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture. Materials and Methods: From March 2004 to March 2006 we have used suture anchor or suture anchors combined with cannulated screw for 6 cases of the greater tuberosity fracture which include displaced fractures, comminuted fractures and minimally displaced fractures with comcomittent lesions such as rotator cuff tears, stiffness and labral lesion. In this retrospective study, we analyzed the clinical outcomes by using the range of motion, University of California at Los Angeles shoulder rating scale (UCLA) and the ASES shoulder index score (ASES) in the average 6 months follow up. Results: At the last follow up, average range of motion was improved to 154.3 degree, 145.8 degree, 32.6 degree and L1 vertebrae in each forward flexion, abduction, external rotation and internal rotation. Clinically the UCLA rating scales improved to 31.5 and the ASES shoulder index score (ASES) improved to 93.6 in the last follow up. Conclusion: Arthroscopic treatments by using suture anchor or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture is an alternative treatment of the greater tuberosity fracture of the proximal humerus fracture.

• Clinics in Shoulder and Elbow
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• v.20 no.4
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• pp.222-229
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• 2017

Background: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. Methods: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. Results: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were $156.7^{\circ}$, $152.2^{\circ}$, $61.1^{\circ}$, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. Conclusions: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.

• Clinics in Shoulder and Elbow
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• v.14 no.1
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• pp.20-26
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• 2011

Purpose: The purpose of this study is to investigate the accompanying lesions of humerus greater tuberosity fracture with anterior shoulder dislocation and to analyze its clinical results. Materials and Methods: From May 2005 to November 2008, arthroscopy was performed on a total of 30 selected patients who were diagnosed with humerus greater tuberosity fracture with anterior shoulder dislocation and who were also under the age of 40. The preoperative and postoperative Constant and Rowe scores were compared. Results: There was a total of 21 cases of anteroinferior labral lesions: 2 Bankart lesions, 4 bony Bankart lesions, 4 Perthes lesions, 2 free ALPSA lesions, 3 GLAD lesions and 6 capsular tears. For other lesions, 5 rotator cuff partial tears, 3 SLAP lesions and 1 biceps tendon rupture were found. The constant scores were increased from 56.3 to 94.43 points (p=0.034), and the Rowe scores were increased from 52.56 to 91.76 points (p=0.026). Conclusion: For humerus greater tuberosity fracture with anterior shoulder dislocation, the accompanying lesion was identified and the fracture was treated using arthroscopy. Good clinical results and bone union were achieved. According to the secondary arthroscopic findings, all of the Perthes lesion, the free ALPSA lesion, the GLAD lesion and the capsular tear spontaneously healed or they did not progress to extended rupture although arthroscopic suture was not performed. Any postoperative secondary instability was not observed.