Arthroscopic Treatment of Greater Tuberosity Avulsion Fractures | Broken Shoulder

Video Description

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This instructional video discusses arthroscopic treatment of greater tuberosity avulsion fractures. This cases study had a greater tuberosity fracture with 6 mm of displacement. After 4 months of non-operative treatment he opted for arthroscopic treatment.

The Hill Sacs lesion is debrided. Subacromial decompression, acromoplasty, and lises of adhesions are performed. Attention is turned to the greater tuberosity fracture. Prior to fracture fixation, the torn superspunatous tendon are mobilized to ensure that they can be reduced anatomically.

Given the size of the bone fragment, the fracture was repaired using a knotless-linked double-row construct with suture anchors and suture tapes. A suture anchor is placed medial to the fracture. A suture shuttling device is used to pass the sutures from the medial row anchor to the rotator cuff tendon. The process is then repeated with a second anchor. The suture anchor is then placed in the lateral part of the greater tuberosity.

The construct prevents over reduction and under reduction and tilting of the fragment. The shoulder is then taken through passive range of motion to asses the construct. Following surgery, the patient is placed in a sling with abduction pillows. Immediately begin active range of motion of elbow, wrist and fingers. 10 days post-op passive range of motion begins and then after 4 weeks active range of motion and after 6 weeks, resisted elbow flexion exercises begin. After 8 weeks, shoulder strengthening starts.

To learn more about arthroscopic treatment of the greater tuberosity avulsion fractures, please visit Dr. Millett's website: http://drmillett.com/.