Analysis of Risk Factors for Occult Surgical Neck Fracture Accompanying Isolated Greater Tuberosity Fracture of Humerus

Abstract

Purpose: An occult surgical neck fracture can be accompanied in isolated greater tuberosity fracture of humerus. The risk factors of occult surgical neck fracture in isolated greater tuberosity fracture were statistically analyzed. Methods: From 2008 to 2017, 74 patients with isolated greater tuberosity fracture of humerus were selected. The occult surgical neck fracture was evaluated by computed tomography or magnetic resonance imaging. Patients were divided into two groups, those with isolated greater tuberosity fractures (group I) and isolated greater tuberosity fractures with occult surgical neck fracture (group II). For the risk factor analysis, the age, sex, underlying disease, injury mechanism, and body mass index between the two groups were compared. Radiologically, fracture pattern, the amount of displacement, and the presence and direction of the shoulder joint dislocation were compared.Results: In multivariate analysis, factors independently related to the occurrence of occult surgical neck fractures were gender and whether or not the joint dislocation. In women (odds ratio [OR]=14.806; 95% confidence interval [CI], 1.188–184.503; p=0.036) and in cases where no joint dislocation occult surgical neck fracture (OR=0.018; 95% CI, 0.001–0.271; p=0.004) was accompanied more frequently and occurred statistically.Conclusion: Care must be taken in cases of female and the absence of shoulder dislocation in isolated greater tuberosity fracture because of the possibility of occult surgical neck fracture.