Arthroscopic percutaneous inverted mattress suture fixation of isolated greater tuberosity fracture of humerus

Objective: The purpose of the study was to evaluate the clinical and radiographic outcomes of treatment in patients with isolated greater tuberosity (GT) fractures of humerus using arthroscopic percutaneous inverted mattress suture fixation technique. Materials and methods: We attempted to use the arthroscopic percutaneous inverted mattress suture fixation technique in 17 consecutive cases with isolated displaced GT fractures. Fourteen patients were successfully treated without switching to other methods and were available for follow-up at a mean of 22 months (range: 17–38 months) after surgery. For assessment of clinical outcomes, we evaluated the range of motion and the visual analog scale (VAS) score, the shoulder index of the American Shoulder and Elbow Surgeons (ASES), and the Korean Shoulder Scale (KSS). Results: At the final follow-up, the VAS improved to 1.0 points (range: 0–3), the mean ASES score improved to 86.9 points (range: 78.3–100) and the KSS improved to 88.6 points (range: 82–100) postoperatively. Mean union time was 10 weeks. Mean forward flexion was 167.8° (range: 140–180°), mean external rotation in neutral position was 36° (range: 20–70°), and mean internal rotation was at the 12th thoracic level (range: T6–L3) at final follow-up. Three cases were switched to open surgery after attempted arthroscopic technique due to large fragment or osteoporosis. Conclusion: In select cases, the arthroscopic percutaneous inverted mattress suture fixation of GT fracture is a simple and reproducible technique with encouraging early results.