title: Arthroscopic tuberoplasty for subacromial impingement secondary to proximal humeral malunion.
abstract: Subacromial impingement secondary to malunion of proximally displaced greater tuberosity fractures may be treated with arthroscopic acromioplasty in patients with slight displacements, but open anatomical repositioning of the malunited fragment is recommended when more severe deformities exist. This deformity may also be addressed by abrading the protruding proximal portion of the greater tuberosity (tuberoplasty). However, this procedure would require full elevation of the rotator cuff insertion if performed with open surgery. This article reports a technique of arthroscopic tuberoplasty based on combined intra- and extra-articular transtendinous abrasion of the proximal end of the greater tuberosity for malunions with severe upward displacement of the greater tuberosity. This procedure allows for major preservation of the rotator cuff insertion.
authors.affiliation: Shoulder Surgery Unit, Department of Orthopaedic Surgery, Fundación Jiménez Díaz, Avda. Reyes Católicos, 2, 28040 Madrid, Spain. ecalvo@fjd.es
authors.forename: Emilio
authors.initials: E
authors.lastname: Calvo
authors.forename: Ignacio
authors.initials: I
authors.lastname: Merino-Gutierrez
authors.forename: Iván
authors.initials: I
authors.lastname: Lagunes
mesh_terms: D001178:Arthroplasty / Q000379:methods*; D017759:Fractures, Malunited / Q000150:complications / Q000601:surgery*; D006801:Humans; D010027:Osteotomy / Q000379:methods; D012784:Shoulder Fractures; D019534:Shoulder Impingement Syndrome / Q000209:etiology / Q000601:surgery*