Article
Isolated Avulsion Fracture of the Lesser Tuberosity of the Humerus in an Adult: Case Report and Literature Review
Am J Orthop. 2008 December;37(12):627-630
Author and Disclosure Information
Aman Dhawan, MD, Kevin Kirk, DO, Thomas Dowd, MD, and William Doukas, MD
MAJ Dhawan, MC, USA, is Assistant Professor of Surgery, Uniformed Services University of the Health Sciences, Bethesda, Maryland.
MAJ Kirk, MC, USA, is Chief, Orthopaedic Foot and Ankle Surgery, Brooke Army Medical Center, San Antonio, Texas.
CPT Dowd, MC, USA, is Orthopaedic Surgery Resident, Brooke Army Medical Center, San Antonio, Texas.
COL Doukas, MC, USA, is Chairman, Integrated Department of Orthopaedics and Rehabilitation, National Naval Medical Center/Walter Reed Army Medical Center, Bethesda, Maryland/Washington, DC.
Abstract not available. Introduction provided instead.
Isolated avulsion fractures of the lesser tuberosity of the proximal humerus are rare. We report the case of a righthand–dominant woman in her early 30s who sustained such an injury, with an intact subscapularis tendon attached to the lesser tuberosity fragment. Treatment included surgery to restore tension to the subscapularis muscle and maintain the force couple about the shoulder joint. One year after injury, the patient reported no pain, excellent range of motion, and
return to activities.
This case demonstrates the diagnostic challenge of this injury, which requires a high index of suspicion and careful review of orthogonal radiographs and advanced imaging. We also describe our operative technique, including use of heavy, nonabsorbable suture.