{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:45:15Z","timestamp":1790390715268,"version":"4.1.0"},"reference-count":36,"publisher":"British Editorial Society of Bone & Joint Surgery","issue":"5","license":[{"start":{"date-parts":[[2014,5,1]],"date-time":"2014-05-01T00:00:00Z","timestamp":1398902400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/online.boneandjoint.org.uk\/TDM"}],"content-domain":{"domain":["online.boneandjoint.org.uk"],"crossmark-restriction":true},"short-container-title":["The Bone &amp; Joint Journal"],"published-print":{"date-parts":[[2014,5]]},"abstract":"<jats:p>In this study, we describe a morphological classification for greater tuberosity fractures of the proximal humerus. We divided these fractures into three types: avulsion, split and depression. We retrospectively reviewed all shoulder radiographs showing isolated greater tuberosity fractures in a Level I trauma centre between July 2007 and July 2012. We identified 199 cases where records and radiographs were reviewed and included 79 men and 120 women with a mean age of 58 years (23 to 96). The morphological classification was applied to the first 139 cases by three reviewers on two occasions using the Kappa statistic and compared with the AO and Neer classifications. The inter- and intra-observer reliability of the morphological classification was 0.73 to 0.77 and 0.69 to 0.86, respectively. This was superior to the Neer (0.31 to 0.35\/0.54 to 0.63) and AO (0.30 to 0.32\/0.59 to 0.65) classifications. The distribution of avulsion, split and depression type fractures was 39%, 41%, and 20%, respectively. This classification of greater tuberosity fractures is more reliable than the Neer or AO classifications. These distinct fracture morphologies are likely to have implications in terms of pathophysiology and surgical technique.<\/jats:p>\n                  <jats:p>Cite this article: Bone Joint J 2014;96-B:646\u201351.<\/jats:p>","DOI":"10.1302\/0301-620x.96b5.32362","type":"journal-article","created":{"date-parts":[[2014,5,1]],"date-time":"2014-05-01T11:08:48Z","timestamp":1398942528000},"page":"646-651","update-policy":"https:\/\/doi.org\/10.1302\/crossmark-policy","source":"Crossref","is-referenced-by-count":93,"title":["A new morphological classification for greater tuberosity fractures of the proximal humerus"],"prefix":"10.1302","volume":"96-B","author":[{"given":"J.","family":"Mutch","sequence":"first","affiliation":[{"name":"Hopital Sacre-Coeur de Montreal, C-2095\rDepartment of Orthopaedic Research, 5400 Boulevard\rGouin Ouest, Montr\u00e9al, Qu\u00e9bec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Y.","family":"Laflamme","sequence":"additional","affiliation":[{"name":"Hopital Sacre-C\u0153ur de Montreal, C-2095\rDepartment of Orthopaedic Research, 5400 Boulevard\rGouin Ouest, Montr\u00e9al, Qu\u00e9bec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"N.","family":"Hagemeister","sequence":"additional","affiliation":[{"name":"\u00c9cole de Technologie Superieur, A-3652\rDepartment of Engineering, 1100, rue\rNotre-Dame Ouest, Montr\u00e9al, Qu\u00e9bec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Cikes","sequence":"additional","affiliation":[{"name":"Groupe Medical Synergie, Grand-pre\r2B, 1007 Lausanne, Switzerland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. M.","family":"Rouleau","sequence":"additional","affiliation":[{"name":"Hopital Sacre-C\u0153ur de Montreal, C-2095\rDepartment of Orthopaedic Research, 5400 Boulevard\rGouin Ouest, Montr\u00e9al, Qu\u00e9bec, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"42","reference":[{"key":"r1","first-page":"1162","author":"Warner J","year":"2006","journal-title":"Rockwood & Green\u2019s Fractures in Adults"},{"key":"r2","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2007.09.022"},{"key":"r3","doi-asserted-by":"publisher","DOI":"10.1302\/0301-620X.83B7.0831056"},{"key":"r4","doi-asserted-by":"publisher","DOI":"10.5435\/00124635-200710000-00005"},{"key":"r5","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(02)86811-2"},{"key":"r6","first-page":"171","volume":"56","author":"Park TS","year":"1997","journal-title":"Bull Hosp Jt Dis"},{"key":"r7","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1016\/S0030-5898(20)30372-2","volume":"18","author":"Hawkins RJ","year":"1987","journal-title":"Orthop Clin North Am"},{"key":"r8","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2005.02.018"},{"key":"r9","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.06.009"},{"key":"r10","first-page":"223","volume":"10","author":"Olivier H","year":"1986","journal-title":"Orthop Trans"},{"key":"r11","doi-asserted-by":"publisher","DOI":"10.1007\/s00068-003-1229-0"},{"key":"r12","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197052060-00001"},{"key":"r13","doi-asserted-by":"publisher","DOI":"10.2106\/00004623-197052060-00002"},{"key":"r14","volume":"48","author":"Jakob RP","year":"1982","journal-title":"Helv Chir Acta"},{"key":"r15","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2005.02.018"},{"key":"r16","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000233710.42698.3f"},{"key":"r17","unstructured":"No authors listed\n                      AO Foundation. https:\/\/www2.aofoundation.org (date last accessed 24 February 2014)."},{"key":"r18","doi-asserted-by":"crossref","unstructured":"Bhatia DN, de Beer JF, van Rooyen KSThe bony partial articular surface tendon avulsion lesion: an arthroscopic technique for fixation of the partially avulsed greater tuberosity fracture.\n                      Arthroscopy\n                      2007;23:786.e1-6.","DOI":"10.1016\/j.arthro.2006.10.024"},{"key":"r19","doi-asserted-by":"crossref","unstructured":"Fahmy A, Antonakopoulos N, Khan AAcromial impression fracture of the greater tuberosity with massive rotator cuff tear: this need not be a nightmare!\n                      BMJ Case Rep\n                      2011. bcr1120103521: PMCID: PMC3062885.","DOI":"10.1136\/bcr.11.2010.3521"},{"key":"r20","doi-asserted-by":"publisher","DOI":"10.1016\/S0020-1383(00)00016-4"},{"key":"r21","doi-asserted-by":"publisher","DOI":"10.1016\/S1058-2746(03)00177-0"},{"key":"r22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jse.2005.07.004"},{"key":"r23","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"r24","doi-asserted-by":"publisher","DOI":"10.1007\/s00590-008-0325-6"},{"key":"r25","doi-asserted-by":"publisher","DOI":"10.1016\/j.injury.2006.06.009"},{"key":"r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2007.05.003"},{"key":"r27","doi-asserted-by":"publisher","DOI":"10.1053\/jars.2000.9237"},{"key":"r28","doi-asserted-by":"publisher","DOI":"10.1007\/s00167-009-0873-2"},{"key":"r29","doi-asserted-by":"publisher","DOI":"10.1016\/j.arthro.2008.01.009"},{"key":"r30","unstructured":"Codman EAFractures in relation to the subacromial bursa. 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