Evaluation of a Novel Suture-Button Technique for Open Reduction and Internal Fixation in Isolated Fractures of the Greater Tuberosity of the Humerus: A Retrospective Study

The purpose of the study is to present a novel technique for the open reduction and fixation of isolated displaced greater tuberosity (GT) fractures, utilizing a suture-button system, along with an evaluation of its efficacy. We conducted a retrospective study, including 18 patients with isolated tuberosity fractures displaced by more than 5 mm. All patients underwent surgical treatment using open reduction and internal fixation with a suture-button system (Zip Tight), reinforced with high-resistance sutures. The "Constant score," the "ASES (American Shoulder and Elbow Surgeons) score," and range of motion (ROM) were assessed postoperatively, with a minimum follow-up of 18 months. Postoperative X-rays were obtained in the anteroposterior (AP) view with the humerus in a neutral position, as well as in internal and external rotation and axial views. The "Constant score," the "ASES score," and ROM increased significantly, reaching their highest levels at the six-month follow-up and remaining stable up to the 12- and 18-month follow-ups. Postoperatively, the mean anterior flexion reached 145° (range: 100°-170°), and the mean abduction was 142° (range: 95°-170°). At 12 months, no patients exhibited significant problems with internal rotation, with the average reaching the T12 level (range: T7 to the posterior iliac crest). External rotation results were also very satisfactory, with a mean range of 75° (range: 60°-90°). Conclusively, this novel technique could provide a safe and effective surgical solution for the treatment of isolated GT fractures, with minimal complications and positive functional and radiological outcomes.