The influence of displacement on shoulder function in patients with minimally displaced fractures of the greater tuberosity.
BACKGROUND
There is little outcome data on functional results after non-operative treatment of greater tuberosity fractures, and no clear evidence in minimally displaced (1-5 mm) fractures of the greater tuberosity showing that the results of non-operative treatments are good enough. This study assesses the relationship between degree of displacement in non-operatively treated patients and shoulder function.


METHODS
We evaluated the radiographs and function in 135 patients after non-operative treatment of minimally displaced (1-5 mm) fractures of the greater tuberosity at a mean time of 3.7 years (2-20 years) after injury. Shoulder function was assessed using the Vienna Shoulder Score (VSS), the Constant Score (CS) and the UCLA-Score.


RESULTS
97% of the evaluated patients had good or excellent results. Patients with a displacement of more than 3 mm had slightly worse results compared to those with less displacement, but this was not statistically significant. Female patients had significantly better results than male patients, and patients in the eighth and ninth decade had significantly worse results compared to younger patients.


CONCLUSIONS
We recommend non-operative treatment in all patients with minimally displaced fractures of the greater tuberosity, as most obtain very good results. The best results followed treatment with Gilchrist bandages or Mitella slings for 3 weeks, followed by intensive rehabilitation.
Platzer
Patrick
P
University of Vienna Medical School, Department of Traumatology, Waehringer Guertel 18-20, A-1090 Vienna, Austria. patrick.platzer@akh-wien.ac.at
Kutscha-Lissberg
Florian
F
Lehr
Stephan
S
Vecsei
Vilmos
V
Gaebler
Christian
C
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D012737:Sex Factors; D012783:Shoulder Dislocation / Q000628:therapy; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D012785:Shoulder Joint / Q000000981:diagnostic imaging / Q000503:physiopathology*; D015599:Trauma Severity Indices; D016896:Treatment Outcome