The greater and lesser tuberosities are two different bony prominences of the proximal humerus (upper arm bone) that serve as the attachment sites for the rotator cuff muscles of the shoulder. The greater or lesser tuberosities can be fractured and separated from the remainder of the humerus bone with falls, dislocations and other injuries to the shoulder. Displaced fractures of the tuberosities which are separated often require surgery to re-position and fix the tuberosity bone fragments back in normal position to re-attach the associated rotator cuff muscles and restore normal shoulder function. If a tuberosity fracture is only mildly displaced, treatment can be non-operative. Depending on the size and position of the fracture, Dr. Chudik can often repair the tuberosity fracture through small arthroscopic incisions.
Depending on the size and position of the fracture, Dr. Chudik approaches the tuberosity fracture either arthroscopically through small incisions (arthroscopic portals) with a camera or through a limited open incision. The surgery is generally performed as an outpatient surgery (you go home the same day). Dr. Chudik uses the small incisions to look in the shoulder joint with a camera and special instruments are used to repair the fracture and any other problems seen in the joint, such as concomitant labral or rotator cuff tears. Once the fracture is identified, it is repaired with the least invasive method which ranges from sutures, anchors, screws or a plate. During surgery, live X-ray is used to help insure appropriate alignment of all the bone fragments.
Following surgery, your shoulder will be placed in a sling for approximately six weeks while the bone heals. Physical therapy often is needed to mobilize the shoulder, regain range of motion, strength and function. You may return to unlimited activities when there is no pain and full shoulder range of motion, muscle strength and endurance, and functional use has been restored. This usually requires four to six months following a repair of a tuberosity fracture. Dr. Chudik will tell you when it is safe to resume all activities.