PMC9091397_01
Plain anteroposterior radiograph of the right shoulder showing displaced greater tuberosity fracture with no associated subluxation/dislocation.
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F1
Initial impression on plain radiograph anteroposterior (AP) view of the right shoulder showed displaced greater tuberosity fracture with no other obvious bony injury (Fig. 1).
CT scan sagittal cuts (a and b) and axial cuts (c and d) showing greater and lesser tuberosity fragments with head shaft continuity.
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F2
CT scan with sagittal and axial cuts demonstrated comminuted greater tuberosity fracture and displaced lesser tuberosity fracture with head shaft in continuity (Fig. 2a-d).
3-D reconstruction images showing anterior (a) and posterior (b) aspect of the right glenohumeral joint with comminuted greater tuberosity fracture and displaced lesser tuberosity with intact glenohumeral joint.
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F3
CT scan with three-dimensional reconstruction (3-D) was done for further understanding of fracture configuration which confirmed fracture of greater tuberosity which was displaced 10 mm superiorly and 5 mm posteriorly, furthermore, to our surprise, lesser tuberosity fracture displaced 6 mm medially was also noticed (Fig. 3).
Intraoperative picture showing PHILOS plate fixation with both the tuberosities secured to the plate through Ethibond no. 5.
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F4
PH locking plate was applied and the Ethibond sutures were passed through islets of the plates (Fig. 4).
Two years follow-up plain radiographs anteroposterior (a) and lateral (b) views showing anatomical reduction of both the tuberosities with complete radiological healing.
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F5
At 2 years follow-up, plain radiographs of the right shoulder confirmed united greater and lesser tuberosities (Fig. 5a, 5b).