Functional Outcome of Displaced Greater Tuberosity Fractures of the Humerus Treated with Cannulated Cancellous Screw Fixation: A Case Series of 30 Patients

Abstract

Background: Fractures of the greater tuberosity of the humerus are important injuries of the shoulder because the greater tuberosity provides attachment to the supraspinatus, infraspinatus, and teres minor tendons. Displacement of the greater tuberosity can alter rotator cuff biomechanics and may result in subacromial impingement and restricted shoulder movement. Anatomical reduction and stable fixation are therefore important in appropriately selected displaced fractures.

Aim: To evaluate the clinical and radiological outcomes of displaced greater tuberosity fractures of the humerus treated with cannulated cancellous screw fixation.

Materials and Methods: This prospective case series included 25 patients with displaced greater tuberosity fractures of the humerus treated with open reduction and internal fixation using cannulated cancellous screws. Patients with isolated displaced greater tuberosity fractures were included. Patients with open fractures, pathological fractures, associated major proximal humeral fractures, pre-existing shoulder dysfunction, or neurological injury were excluded. Functional outcome was assessed using the Constant-Murley Shoulder Score and range of motion. Serial radiographs were obtained to assess fracture reduction, union, and implant-related complications.

Results: The study included 25 patients, comprising 17 males and 8 females, with a mean age of approximately 42 years. Road traffic accidents were the commonest mechanism of injury. All patients underwent reduction and fixation with cannulated cancellous screws. Radiological union was achieved in all patients, with a mean time to union of approximately 9 weeks. Progressive improvement in shoulder range of motion and Constant-Murley scores was observed during follow-up. Most patients achieved good to excellent functional outcomes. No significant loss of reduction, implant failure, infection, or neurovascular complication was observed.

Conclusion: Cannulated cancellous screw fixation provides stable fixation of appropriately selected displaced greater tuberosity fractures and allows early rehabilitation. Anatomical restoration of the greater tuberosity, careful screw placement, and structured postoperative rehabilitation can result in satisfactory radiological union and functional recovery.