Rotator cuff tears in proximal humeral fractures: an MRI cohort study in 76 patients
- 443 Downloads
The aim was to evaluate if concomitant injury to the rotator cuff is important for functional outcome in proximal humerus fractures, and to relate loss of function to malunion of the fractures.
Materials and methods
A total of 76 patients treated conservatively for proximal humerus fracture were included in this cohort study. Performing an MRI examination at the time of injury and after 12 months, tears of the rotator cuffs were classified as partial- or full thickness. The fractures were classified, according to the AO classification, and the degree of tubercle displacement and humeral head inclination evaluated at 12 months. Constant score was used as outcome measure.
Magnetic resonance imaging (MRI) examinations confirmed 22 rotator cuff tears (four full thicknesses) diagnosed at the time of injury, and 10 additional tears (three full thicknesses) at one year. Functional loss at one year significantly corresponded to the tears at the time of injury (P = 0.004), varus malunion of the head and displacement of tubercles (P < 0.001).
Partial- as well as full thickness tears of the rotator cuff are important for functional outcome. Skeletal deterioration seems even more important.
KeywordsProximal humerus fracture MRI Rotator cuff tear Partial tear AO classification Functional outcome
Conflict of interest statement
The authors declare that they have no conflict of interest.
- 5.Constant CR, Murley AHG (1987) A clinical method of functional assessment of the shoulder. Clin Othop 214:160–164Google Scholar
- 10.Hodgson S, Iannotti J, Evans P (2006) Proximal humerus fracture rehabilitation. Clin Orthop 44(2):131–138Google Scholar
- 11.Müller ME, Nazarian S, Koch P (1990) The comprehensive classification of fractures of long bone. Springer, New YorkGoogle Scholar
- 13.Potter HG, Birchansky SB (2005) Magnetic resonance imaging of the shoulder: a tailored approach. Tech Shoulder Elbow Surg 6(1):43–56Google Scholar
- 15.Siebenrock KA, Gerber C (1993) The reproducibility of classification of fractures of the proximal end of the humerus. J Bone Joint Surg Am 75-A(12):1751–1755Google Scholar
- 16.Teefey SA, Rubin DA, Middleton WD, Hildebolt CF, Leibold RA, Yamaguchi K (2004) Detection and quantification of rotator cuff tears. Comparison of ultrasonographic, magnetic resonance imaging and arthroscopic findings in seventy-one consecutive cases. J Bone Joint Surg Am 86:708–716PubMedGoogle Scholar
- 20.Zanetti M, Wieshaupt D, Jost B, Gerber C, Hodler J (1999) MR imaging for traumatic tears of the rotator cuff: high prevalence of greater tuberosity fractures and subscapularis tendon tears. Am J Roentgenol 172(2):463–467Google Scholar