TY - JOUR
T1 - What are the patient-reported outcomes, functional limitations, and complications after lesser tuberosity fractures? a systematic review of 172 patients
AU - Spek, Reinier W.A.
AU - Schoolmeesters, Bram J.A.
AU - den Haan, Chantal
AU - Jaarsma, Ruurd L.
AU - Doornberg, Job N.
AU - van den Bekerom, Michel P.J.
PY - 2021/7
Y1 - 2021/7
N2 - Background: Lesser tuberosity fractures are relatively rare, with an incidence of 0.46 per 100,000 persons per year. This systematic review was performed to address patient-reported outcomes (PROMs), shoulder function, and complications after lesser tuberosity fractures in pediatric and adult patients, as well as patients with an associated posterior shoulder dislocation. Within these groups, identical outcomes were evaluated for nonoperative, surgical, acute and delayed treatment. Method: A comprehensive search was carried out in multiple databases. Articles were included if patients sustained a lesser tuberosity fracture without a concomitant proximal humerus fracture. There were no restrictions on age, type of treatment, fragment displacement, time to presentation, or associated injuries. Results: One thousand six hundred forty-four records were screened for eligibility of which 71 studies were included (n = 172). Surgical treatment was provided to 50 of 62 (81%) pediatric patients, 49 of 66 (74%) adults, and 34 of 44 (77%) patients with an associated posterior shoulder dislocation. In the pediatric group, the mean of PROMs was 94 (range 70-100) and among adults 89 (range 85-100). In the posterior shoulder dislocation group, 89% did not regain full range of motion and the complication rate was 17%. In pediatric patients, surgery was associated with fewer complications (P = .021) compared to nonoperative treatment. Conclusion: Pediatric patients have excellent outcomes after lesser tuberosity fractures and respond well to surgical treatment. Adults have acceptable outcomes but patients with an associated posterior shoulder dislocation have impaired range of shoulder movement and are more likely to develop complications.
AB - Background: Lesser tuberosity fractures are relatively rare, with an incidence of 0.46 per 100,000 persons per year. This systematic review was performed to address patient-reported outcomes (PROMs), shoulder function, and complications after lesser tuberosity fractures in pediatric and adult patients, as well as patients with an associated posterior shoulder dislocation. Within these groups, identical outcomes were evaluated for nonoperative, surgical, acute and delayed treatment. Method: A comprehensive search was carried out in multiple databases. Articles were included if patients sustained a lesser tuberosity fracture without a concomitant proximal humerus fracture. There were no restrictions on age, type of treatment, fragment displacement, time to presentation, or associated injuries. Results: One thousand six hundred forty-four records were screened for eligibility of which 71 studies were included (n = 172). Surgical treatment was provided to 50 of 62 (81%) pediatric patients, 49 of 66 (74%) adults, and 34 of 44 (77%) patients with an associated posterior shoulder dislocation. In the pediatric group, the mean of PROMs was 94 (range 70-100) and among adults 89 (range 85-100). In the posterior shoulder dislocation group, 89% did not regain full range of motion and the complication rate was 17%. In pediatric patients, surgery was associated with fewer complications (P = .021) compared to nonoperative treatment. Conclusion: Pediatric patients have excellent outcomes after lesser tuberosity fractures and respond well to surgical treatment. Adults have acceptable outcomes but patients with an associated posterior shoulder dislocation have impaired range of shoulder movement and are more likely to develop complications.
KW - Adults
KW - Lesser tuberosity fracture
KW - Level IV
KW - Outcomes
KW - Pediatric patients
KW - Posterior shoulder dislocation
KW - Subscapularis avulsion
KW - Systematic Review
KW - Systematic review
UR - http://www.scopus.com/inward/record.url?scp=85108318162&partnerID=8YFLogxK
U2 - 10.1016/j.jseint.2021.02.016
DO - 10.1016/j.jseint.2021.02.016
M3 - Review article
AN - SCOPUS:85108318162
SN - 2666-6383
VL - 5
SP - 754
EP - 764
JO - JSES International
JF - JSES International
IS - 4
ER -