An Isolated Greater Tuberosity Fracture With Posterior-Superior Displacement in an Elderly Patient: Successful Fixation Using Cannulated Screws With Washers Without Rotator Cuff Repair

Isolated fractures of the greater tuberosity are uncommon, comprising a minority of proximal humerus fractures. Their management depends primarily on the degree and direction of displacement. Posterior-superior displacement, in particular, is associated with subacromial impingement and compromised rotator cuff function, often necessitating surgical intervention. This case report aims to present the management of an isolated greater tuberosity fracture with posterior-superior displacement in an elderly patient, emphasizing successful fixation with interfragmentary screws, without rotator cuff repair. We present the case of a 59-year-old female who sustained an isolated greater tuberosity fracture with significant posterior-superior displacement following an anterior shoulder dislocation. The patient was treated successfully with open reduction and internal fixation (ORIF) using cannulated screws with washers, without concurrent rotator cuff repair, as the tendons were intact, and anatomical reduction of the greater tuberosity fragment with screw fixation was sufficient to restore cuff function. Postoperative rehabilitation was initiated early, and the patient achieved full, pain-free range of motion and complete recovery of shoulder function within three months. The ASES (American Shoulder and Elbow Surgeons) and Constant scores were 90 and 88, respectively. This case demonstrates that interfragmentary screw fixation alone can yield excellent clinical outcomes in selected elderly patients, even in the absence of additional rotator cuff repair. Emphasis should be placed on accurate assessment of displacement via computed tomography (CT) imaging, and timely surgical intervention followed by structured rehabilitation.