PMC4529671_01
Preoperative anteroposterior radiograph showing fractures of the lesser tuberosity and scapular spine. Plate fixation of a clavicle fracture sustained four years prior to the current trauma was intact.
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An anteroposterior (AP) radiograph (Fig. 1) and CT scans (Fig. 2) revealed left-sided displaced LTF and SSF, without any signs of posterior dislocation of the glenohumeral joint.
Intraoperative view of the (A) exposed lesser humeral tuberosity fracture, (B) open reduction with stay sutures, and (C) internal fixation with the 5-hole LCP T-plate: white arrow indicates the tenotomy of the long head of the biceps. (D) ORIF of scapular spine fracture with LCP Radial Distal Humerus Plate.
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Stay sutures were used for anatomical reduction of the fragment (Fig. 3a and b). AG, Switzerland), which achieved anatomic reduction and stable fixation (Fig. 3c). After soft tissue tenodesis of the long head of the biceps, the wound was closed over a Redon drain. AG, Switzerland) (Fig. 3d). A lag screw over the plate was used to gain additional fracture compression.
Six-month postoperative clinical outcome for the patient revealing limited internal rotation (D).
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Only internal rotation remained limited at one year (Fig. 4).
One-year postoperative anteroposterior (A: external rotation; B: internal rotation) and axillary view (C) radiographs after ORIF with a 5-hole LCP T-plate and distal humerus plate for the lesser tuberosity and scapular spine, respectively.
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Both fractures were healed with all implants intact (Fig. 5); the patient did not agree to the proposed implant removal to increase internal rotation as he was satisfied with the result.