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Orthopaedics & Traumatology: Surgery & Research
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le jeudi 10 janvier 2019
Doi : 10.1016/j.otsr.2018.06.017
Received : 3 August 2017 ;  accepted : 29 June 2018
Risk factors for secondary displacement in conservatively treated isolated greater tuberosity fractures: An analysis of 82 cases

Benjamin Bockmann a, Philipp Lechler b, Christoph Kolja Boese c, Rene Aigner b, Steffen Ruchholtz b, Michael Frink b,
a Department of Orthopaedics and Trauma Surgery, St. Josef Hospital, Ruhr University Bochum, 44791 Bochum, Germany 
b Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstraße, 35043 Marburg, Germany 
c Department of Orthopedic and Trauma Surgery, University Hospital of Cologne, Kerpener Straße 62, Cologne, Germany 

Corresponding author at: Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, Baldingerstraße, 35043 Marburg, Germany.Center for Orthopaedics and Trauma Surgery, University Hospital Giessen and Marburg, Location Marburg, BaldingerstraßeMarburg35043Germany

The optimal treatment of isolated fractures of the greater tuberosity is an important topic of current surgical research. While non-displaced fractures are amenable to conservative treatment, displacement of the fragment can result in rotator cuff malfunction and impingement. For the present study, risk factors predicting secondary fragment displacement were analyzed.


Certain risk factors determine a higher risk of secondary displacement in patients with greater tuberosity fractures.

Patients and methods

All patients diagnosed with a fracture of the greater tuberosity and initially treated non-surgically at our Level I trauma center between January 2008 and July 2015 were included in this retrospective analysis. Patients were grouped into: no secondary displacement (group 1) and secondary displacement at follow-up (group 2). The following risk factors were analyzed: age, gender, side of fracture, initial displacement, fragment/head ratio, fragment shape, dislocation, concomitant fractures and concomitant fractures to the same extremity.


82 patients (42 male, 40 female) were eligible for further analyses. Median follow-up was 8.0±39.5 days. Patients with secondary displacement (group 2) were significantly older (group 1: 51.7±15.5, group 2: 68.3±14.3; p <0.001) and had significantly more shoulder dislocations (p =0.024), whereas gender (p =0.299), side of fracture (p =0.189) and fragment/head ratio (p =0.660) showed no significant different distribution between both groups. Finally, split-type fractures increased the risk of secondary displacement.


The present study identified age older than 65 years to be an important risk factor for secondary displacement in the conservative management of fractures of the greater tuberosity. Furthermore, fracture type and shoulder dislocations are factors associated with an increased relative risk for secondary displacement.

Level of proof

III, Retrospective comparative study.

The full text of this article is available in PDF format.

Keywords : Greater tuberosity fractures, Secondary displacement, Shoulder dislocation, Risk factor

© 2018  Published by Elsevier Masson SAS.
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