Functional Outcome of Isolated Greater Tuberosity Fracture Humerus with Low-profile Anatomical Proximal Humerus...

Isolated greater tuberosity (GT) fractures constitute approximately 20% of proximal humeral fractures and predominantly affect younger, active individuals. While minimally displaced fractures respond well to conservative treatment, displacement exceeding 5 mm often results in subacromial impingement and rotator cuff dysfunction, necessitating surgical intervention. Despite various fixation techniques available, optimal management remains debated. This study evaluates the functional and radiographic outcomes of a low-profile anatomical locking plate specifically designed for GT fractures.

This prospective study, conducted from June 2023 to November 2024, included 30 patients with displaced isolated GT fractures treated surgically using a low-profile anatomical proximal humerus GT plate via a deltoid-splitting approach. Patients were followed clinically and radiographically at regular intervals up to 6 months. Functional outcomes were assessed using the Constant-Murley Score, Disabilities of the Arm, Shoulder, and Hand (DASH) score, American Shoulder and Elbow Surgeons (ASES) score, and Visual Analog Scale (VAS) for pain. Range of motion and complications were documented.

The mean patient age was 42.6 ± 10.3 years with male predominance (60%). Mean fracture displacement was 6.7 ± 1.5 mm superiorly and 7.9 ± 1.8 mm posteriorly. Surgery was performed at a mean of 4.6 ± 1.2 days postinjury with an operative time of 65.2 ± 8.5 min. At final follow-up (mean 17.2 ± 4 months), the mean ASES score was 81.3 ± 9.4, constant score improved from 41.6 at 1 month to 75.8 at 6 months, DASH score decreased from 48.5 to 14.2, and VAS reduced from 5.8 to 1.8. All fractures achieved union. Complications included restricted abduction in 10% and superficial infection in 3.3%, with no implant failures.

Low-profile anatomical locking plates provide excellent functional outcomes, reliable fracture healing, and minimal complications in displaced GT fractures, representing a dependable surgical option facilitating early mobilization and functional recovery.