Abstract
Purpose: The aim of this study was to evaluate the arthroscopic findings and treatment of chronic shoulder pain after minimally displaced greater tuberosity (GT) fractures.
Material and Methods: Arthroscopy was performed in 12 patients (8m, 4f; mean age of 36 years) with more than 6 months of shoulder pain after sustaining a minimally displaced GT fracture (inferior to 5 mms). 4 cases were associated with anterior shoulder dislocation.
Results: Varied pathologic findings, some of them unsuspected, were observed in all cases, both at subacromial and glenohumeral level:
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5 cases of subacromial impingement secondary to protrusion of the proximal portion of the GT; 2 of them associated with Pasta lesion
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3 cases of unstable – non united bony fragments at subacromial level
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4 cases of isolated Pasta lesions, 2 pure tendinous and 2 “bony” with unstable osteocondral fragments.
All lesions were arthroscopically treated: GT tuber-oplasty, repair of Pasta lesions, suture fixation of GT fragments. After minimum follow-up of one year, Constant and Simple Shoulder Test scores were significantly improved.
Conclusions: Arthroscopy proved to be very useful to assess the varied etiologic factors for chronic shoulder pain in undisplaced GT fractures. Arthroscopic techniques are effective in managing GT malunions and tendinous and bony Pasta lesions.
Correspondence should be addressed to: EFORT Central Office, Technoparkstrasse 1, CH – 8005 Zürich, Switzerland. Tel: +41 44 448 44 00; Email: office@efort.org
Author: Ricardo De Casas, Spain
E-mail: drdecasas@traumacor.es
