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Risk factors for secondary displacement in conservatively treated isolated greater tuberosity fractures: An analysis of 82 cases.

Abstract：

INTRODUCTION: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. HYPOTHESIS: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. RESULTS: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. DISCUSSION: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.

journal_name

Orthop Traumatol Surg Res

journal_title

Orthopaedics & traumatology, surgery & research : OTSR

authors

Bockmann B,Lechler P,Boese CK,Aigner R,Ruchholtz S,Frink M

doi

10.1016/j.otsr.2018.06.017

subject

Has Abstract

pub_date

2019-04-01 00:00:00

pages

317-322

issue

issn

1877-0568

pii

S1877-0568(18)30271-8

journal_volume

105

pub_type

杂志文章

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Risk factors for secondary displacement in conservatively treated isolated greater tuberosity fractures: An analysis of 82 cases.