Modified Hook Wiring Technique for Greater Tuberosity Fractures: A Prospective Study

Area of Science:

• Orthopedic Surgery
• Traumatology
• Sports Medicine

Background:

• Managing displaced greater tuberosity (GT) fractures, particularly with glenohumeral (GH) dislocations, requires balancing stable fixation and early mobilization.
• Optimal surgical fixation techniques for GT fractures are debated due to potential complications and variable outcomes.

Purpose of the Study:

• To evaluate the outcomes of the Modified Hook Wiring (MHW) technique for open reduction and internal fixation of isolated displaced GT fractures.
• To assess the efficacy and safety of MHW in promoting stable fixation and early shoulder function.

Main Methods:

• A prospective study involving 13 patients with displaced GT fractures treated with MHW.
• Patients underwent open reduction and internal fixation using the MHW technique.
• Functional outcomes were assessed using Constant-Murley and ASES scores, range of motion, and subjective shoulder value.

Main Results:

• All 13 patients achieved complete fracture healing by an average of 9.7 weeks without displacement or malunion.
• Average Constant-Murley and ASES scores were 77.9 and 83.1 respectively at one year.
• Mean forward flexion was 148°, abduction 142.3°, with a low mean VAS pain score of 1.46.

Conclusions:

• The MHW technique provides stable fixation and reliable union for displaced GT fractures, including those with GH dislocations.
• This method facilitates early shoulder mobilization and demonstrates satisfactory functional outcomes with a low complication rate.
• MHW is a promising alternative for treating displaced GT fractures, potentially offering advantages over conventional fixation methods.