Fractures of the Greater Tuberosity
The greater tuberosity is the “bump” of bone at the top of the humerus that serves as the attachment for two rotator cuff muscles. This attachment is why a fracture can also interfere with the functioning of the rotator cuff.
These fractures can be displaced or nondisplaced. A displaced fracture is one that is out of its normal position. Displaced fractures are not very common and they normally occur alongside anterior shoulder dislocations. In this type of fracture, the greater tuberosity detaches from its attached rotator cuff. It consequently gets pulled away from the correct placement by the attached tendons.
Undisplaced fractures can be difficult to diagnose as they often do not show up on x-rays. With this type of injury, the x-ray might look completely normal. This is often the case in skiing and mountain biking injuries. Sometimes it may not be able to be diagnosed until a few weeks after the injury when it has not started to heal. With an MRI or an ultrasound of the shoulder, this injury is much more visible.
Fractures of the Greater Tuberosity Causes
These fractures occur as the result of a fall where someone lands directly on the side of their shoulder or lands with their arm outstretched. It might fracture alone or in combination with other injuries of the shoulder joint.
The greater tuberosity fragment can be pulled off when the rotator cuff muscle contracts or the anterior shoulder dislocates. Direct impact to the shoulder can cause the bone to break into multiple fragments.
Often, these fractures are seen in cases of shoulder dislocations and in patients with osteoporosis. Diabetes and epilepsy are other factors that may put an individual at a greater risk of a greater tuberosity fracture. In addition, women tend to experience these fractures twice as often as men.
Fractures of the Greater Tuberosity Symptoms
Often, patients will experience pain and swelling of the shoulder after this fracture. They may also have difficulty or an inability to move their shoulder.
Fractures of the Greater Tuberosity Treatment
The best treatment for this injury depends on its severity. If the bones are still in their normal position, the arm may need to be put in a sling. Other treatments may include rest, ice, and anti-inflammatory medication. Once the shoulder has healed, physical therapy may also be recommended. Unfortunately, it might take a long time for these fractures to heal and for the pain to go away. Also, shoulder stiffness and frozen shoulder are somewhat common after an undisplaced fracture of the greater tuberosity. Sometimes it could take up to one year for the fracture to fully heal.
For severe fractures where the bones move out of position, surgery might be necessary. This will ensure that the bones heal in the correct position.
Fractures of the Greater Tuberosity at OAR
If you suspect you have sustained a fracture of the greater tuberosity, contact us at Orthopaedic Associates of Riverside. We will be able to provide you with the best treatment so you can get back to your favorite activities in no time.