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Isolated fracture of the tuberosities of the humerus: causes, symptoms, diagnosis, treatment
Last reviewed: 05.07.2025
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What causes an isolated humeral tuberosity fracture?
Isolated fractures of the humeral tubercles mostly occur with an indirect mechanism of injury, a common type of which are avulsion fractures. The latter almost always occur with displacement of fragments.
Symptoms of an isolated fracture of the humeral tuberosities
Patients complain of pain at the site of the fracture and limited movement in the shoulder joint.
Diagnosis of isolated fracture of humeral tuberosities
Inspection and physical examination
The proximal shoulder is swollen, sometimes a bruise and other signs of violence are visible. Palpation reveals sharp pain in the projection of the tubercles. Active movements in the shoulder joint are limited - rotation and abduction are difficult, passive movements are possible, but painful.
Laboratory and instrumental studies
The final diagnosis is made after mandatory X-rays, since fractures of the tubercles in some cases are not diagnosed, referring them to shoulder contusions.
[ Treatment of isolated fracture of the humeral tubercles
Conservative treatment of isolated fracture of humeral tuberosities
In case of fractures without displacement, after procaine blockade (10 ml of 1% solution), a Desault plaster cast is applied with a wedge-shaped pad in the armpit, creating an abduction of at least 30° for 3 weeks. After the immobilization is eliminated, a course of restorative treatment is prescribed.
In case of fractures with displacement, the fragments are aligned and an abduction splint or plaster thoracobrachial bandage is applied. The shoulder is abducted by 90°, shifted forward by 30°. The remaining segments of the arm are given a functionally advantageous position. Immobilization continues for 6 weeks, then rehabilitation treatment is prescribed.
Surgical treatment of isolated fracture of humeral tubercles
A rupture of the greater tubercle with its displacement under the acromion is an indication for surgical treatment. Open osteosynthesis is performed with a metal screw, Kirschner wires or transosseous sutures with chromic catgut. Immobilization is mandatory after the operation. Further tactics and terms are the same as for conservative treatment.