Arch Hand Microsurg.  2020 Mar;25(1):17-23. 10.12790/ahm.19.0065.

Analysis of Risk Factors for Occult Surgical Neck Fracture Accompanying Isolated Greater Tuberosity Fracture of Humerus

Affiliations
  • 1Department of Orthopedic Surgery, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, Korea
  • 2Department of Orthopedic Surgery, Bucheon Hi Hospital, Bucheon, Korea
  • 3Department of Orthopedic Surgery, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Daejeon, Korea

Abstract

Purpose
An occult surgical neck fracture can be accompanied in isolated greater tuberosity fracture of humerus. The risk factors of occult surgical neck fracture in isolated greater tuberosity fracture were statistically analyzed.
Methods
From 2008 to 2017, 74 patients with isolated greater tuberosity fracture of humerus were selected. The occult surgical neck fracture was evaluated by computed tomography or magnetic resonance imaging. Patients were divided into two groups, those with isolated greater tuberosity fractures (group I) and isolated greater tuberosity fractures with occult surgical neck fracture (group II). For the risk factor analysis, the age, sex, underlying disease, injury mechanism, and body mass index between the two groups were compared. Radiologically, fracture pattern, the amount of displacement, and the presence and direction of the shoulder joint dislocation were compared.
Results
In multivariate analysis, factors independently related to the occurrence of occult surgical neck fractures were gender and whether or not the joint dislocation. In women (odds ratio [OR]=14.806; 95% confidence interval [CI], 1.188–184.503; p=0.036) and in cases where no joint dislocation occult surgical neck fracture (OR=0.018; 95% CI, 0.001–0.271; p=0.004) was accompanied more frequently and occurred statistically.
Conclusion
Care must be taken in cases of female and the absence of shoulder dislocation in isolated greater tuberosity fracture because of the possibility of occult surgical neck fracture.

Keyword

Isolated greater tuberosity fracture; Humeral surgical neck; Occult fracture; Risk factors

Figure

  • Fig. 1. (A) Radiography of a 53-year-old female patient showing a greater tuberosity fracture of right humerus with shoulder dislocation. (B, C) Magnetic resonance images after reduction showing greater tuberosity fracture.

  • Fig. 2. (A) Radiography of a 62-year-old female patient showing a greater tuberosity fracture of left humerus. (B, C) Magnetic resonance images showing occult surgical neck fracture of humerus accompanying greater tuberosity fracture.


Reference

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