Korrelation zwischen Unfallmechanismus und röntgenmorphologischem Befund bei Frakturen des Tuberculum majus humeri

Only a few publications discuss mechanisms of injury and the morphology of greater tuberosity fractures. Often, it is described as an avulsion fracture of the rotator cuff. The exact pathobiomechanics is uncertain. We evaluated mechanism of injury, fracture morphology and displacement in 103 patients over a 16-year-period. 59 patients sustained a greater tuberosity fracture as part of a traumatic shoulder dislocation. In 44 cases an isolated greater tuberosity fracture was diagnosed. 59,8% of the patients reported a direct and 40,2% an indirect mechanism of injury. There was one abduction-external rotation mechanism thought to be the cause of a greater tuberosity fracture. Radiological evaluation revealed in 25% of the cases an inferior displacement of the fracture in the a.p-view. Our data contradicts the theory that this fracture is the result of a bony avulsion of the rotator cuff. Potential mechanisms of injury are discussed. We conclude that there has to be a specific mechanism of injury for greater tuberosity fractures. Further investigations would be beneficial.