title: Arthroscopic management of occult greater tuberosity fracture of the shoulder.
abstract: OBJECTIVE
  The purpose of this retrospective study was to evaluate the early results of arthroscopic treatment in patients with missed occult greater tuberosity (GT) fracture of the humerus using the arthroscopic suture-bridge fixation technique.
  
  
  METHODS
  Between January 2007 and August 2010, we used arthroscopic suture-bridge fixation in 15 cases of missed occult GT fractures, which were referred to our department with persistent symptoms following trauma, despite physical therapy. Occult GT fracture was diagnosed with bone marrow edema seen on magnetic resonance imaging in all patients. There were 13 male and 2 female patients with a mean age of 45 years (range 31-67 years). Mean time period until the surgery following the initial trauma was 4 months (1.5-12 months). For the measurement of clinical outcomes, we assessed the range of motion and evaluated the University of California, Los Angeles (UCLA) American Shoulder and Elbow Surgeons (ASES) scores and simple shoulder test (SST).
  
  
  RESULTS
  The early clinical results were evaluated in these patients at a mean of 24 months (range 14-36 months) after surgery. All the patients were satisfied with the surgery. The mean UCLA, ASES, and SST scores improved from preoperative 15, 39, and 2 to postoperative 33, 91, and 11, respectively (P < .05). Mean forward flexion, abduction, external rotation at the neutral position, and internal rotation were improved to 159°, 155°, 24°, and L1, respectively, at the final follow-up.
  
  
  CONCLUSIONS
  In the occult GT fracture with persistent shoulder symptoms, arthroscopic suture-bridge fixation and early rehabilitation showed excellent clinical outcomes on a short-term follow-up study.
  
  
  METHODS
  Retrospective review, Level IV.
authors.affiliation: Department of Orthopedic Surgery, College of Medicine, The Catholic University of Korea, Daejeon St. Mary's Hospital, 520-2, Deahung-Dong, Joong-Gu, Daejeon, 302-803, Republic of Korea.
authors.forename: Sang-Eun
authors.initials: SE
authors.lastname: Park
authors.forename: Jong-Hun
authors.initials: JH
authors.lastname: Ji
authors.forename: Mohamed
authors.initials: M
authors.lastname: Shafi
authors.forename: Jae Jung
authors.initials: JJ
authors.lastname: Jung
authors.forename: Ho-Jin
authors.initials: HJ
authors.lastname: Gil
authors.forename: Hwan-Hee
authors.initials: HH
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D001182:Arthroscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016268:Internal Fixators; D008297:Male; D008875:Middle Aged; D011859:Radiography; D020127:Recovery of Function; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013536:Suture Techniques
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