Greater Tuberosity Fracture of the Humerus: Arthroscopic Fixation

Isolated fractures of the greater tuberosity are a relatively uncommon pathology and can lead to issues in strength, range of motion, and pain if not adequately reduced and fixed. Treatment decision mainly depends on the displacement of the fragment but most of the time it requires surgery because of the mechanics of the cuff that pulls on the fragment, making it unstable. If mistreated or unrecognized, the patients could develop chronic pain and limitations in range of motion that can lead to diminished function of the shoulder. Surgical alternatives include close reduction and percutaneous fixation, open or arthroscopic-assisted reduction, and internal fixation. In recent years, the advancements in shoulder arthroscopy have yielded arthroscopically assisted fixation techniques with encouraging results. The purpose of this Technical Note is to describe a suture bridge arthroscopic technique for treating a comminuted fracture of the greater tuberosity using multiple suture anchors. This technique has been found to be helpful in cases of greater tuberosity comminution to bridge the bony fragments.