{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:34:34Z","timestamp":1787754874664,"version":"build-2784847793"},"reference-count":59,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      <jats:list list-type=\"plain\">\n                        <jats:list-item>\n                          <jats:p>\u00bb Isolated greater tuberosity (GT) fractures account for approximately 20% of all proximal humerus fractures.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Displaced GT fractures can compromise the rotator cuff biomechanics and behave as rotator cuff deficient shoulders, leading to weakness (external rotation and scaption strength), loss of range of motion (elevation, abduction, external rotation), and subacromial impingement.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Most nondisplaced to minimally displaced fractures (&lt;5 mm) can be treated nonsurgically with good outcomes. Secondary displacement of GT fractures is low, but the presence of associated shoulder instability predisposes patients to a higher risk, and thus, these patients should be monitored closely.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Displaced fractures benefit from surgical treatment. A tension band construct or buttressing mechanism is required to neutralize the deforming force of the posterior and superior rotator cuff on fracture fixation.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb There is no consensus on the surgical approach (arthroscopic vs. open) and type of fixation (plate, screws alone, suture anchor repair, or hybrid fixation) for the surgical treatment of these fractures. Each fixation option has its own unique profile of advantages and risks, emphasizing the importance of individualized management.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Small (&lt;1 cm) avulsion or depressed type fractures are amenable to arthroscopic treatment with suture anchor repair, with or without screw fixation, resulting in good outcomes.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>\u00bb Open repair is more common in split type fracture patterns or fractures with a large fracture fragment. There is no consensus on the surgical approach (deltopectoral vs. anterolateral or lateral deltoid approach) for open repair.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.26.00013","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T18:00:19Z","timestamp":1779818419000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of Greater Tuberosity Fracture: Evidence-Based Strategies for Treatment and Best Practices"],"prefix":"10.2106","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-391X","authenticated-orcid":false,"given":"Tej","family":"Joshi","sequence":"first","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4679-6828","authenticated-orcid":false,"given":"Dario","family":"Fucich","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0575-2482","authenticated-orcid":false,"given":"Swara R.","family":"Kalva","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-6309-6025","authenticated-orcid":false,"given":"Arthur J.","family":"Perry","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9950-5273","authenticated-orcid":false,"given":"Jie J.","family":"Yao","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6294-2771","authenticated-orcid":false,"given":"Mandeep S.","family":"Virk","sequence":"additional","affiliation":[{"name":"Division of Shoulder and Elbow Surgery, Department of Orthopedic Surgery, NYU Grossman School of Medicine, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, New York"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,5]]},"reference":[{"issue":"4","key":"r1-20260526","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1080\/000164701753542023","article-title":"The epidemiology of proximal humeral fractures","volume":"72","author":"Court-Brown","year":"2001","journal-title":"Acta Orthop Scand"},{"issue":"3","key":"r2-20260526","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1302\/0301-620X.93B3.25083","article-title":"The pattern of the fracture and displacement of the fragments predict the outcome in proximal humeral fractures","volume":"93-B","author":"Foruria","year":"2011","journal-title":"J Bone Joint Surg Br"},{"issue":"6","key":"r3-20260526","doi-asserted-by":"crossref","first-page":"714","DOI":"10.3109\/17453674.2011.618912","article-title":"Isolated fractures of the greater tuberosity of the proximal humerus: a long-term retrospective study of 30 patients","volume":"82","author":"Mattyasovszky","year":"2011","journal-title":"Acta Orthop"},{"issue":"5","key":"r5-20260526","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1302\/0301-620X.79B5.0790857","article-title":"The three-dimensional geometry of the proximal humerus. 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