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Met with an accident. MRI showed avulsion of greater tuberosity of humerus. Do I need surgery?

Feb 2014
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 2004
Answered : 5930 Questions
Hi, I had a bad fall eight weeks ago on my shoulder and went to the accident and emergency in hospital the same day. I was given an x-ray and was told nothing was broken and it was a torn muscle. Basically through getting an MRI scan referred by my own doctor I found that I had suffered an avulsion of the right humerus of greater tuberosity.The original x-ray had showed this all along but wasn't spotted. After being referred to an orthopaedic clinic in hospital I got another x-ray which showed the avulsion but I was told that because it was past four weeks since the accident the surgeon would be unable to operate and put a pin through it, and to refrain from lifting my arm too high as the muscles will try to pull on the avulsion and make it worse. My last visit to the hospital was a few days ago and I was told to try and get the muscles moving, which contradicts the previous advice. My arm is still quite sore and my doctor wrote this of my limitations - tender subacromial space, not tender AC or SC joints, 45 degrees abduction, normal retroflexion, subnormal anteflexion, unable to actively posteriorly rotate, pain on passive rotation, which is limited, also a traumatic injury right from day 1 of the injury, and what is the best thing I can do for my injury right now, and will I need surgery in the future? I have not been back to work since the accident, as I work in the postal service and is quite a manual job.
Posted Sun, 10 Mar 2013 in Bones, Muscles and Joints
Answered by Dr. Saurabh Gupta 1 hour later
Thanks for posting your query.

Correct course of treatment right from day 1 depend on displacement of fracture.It is generally accepted that undisplaced and slightly displaced (≤ 5 mm) fractures of the greater tuberosity should be treated non-surgically.Surgical open reduction XXXXXXX fixation is the treatment option of choice for displaced fractures(> 5 mm).

Let me know how much displacement of avulsion of greater tuberosity present. You have a feature to upload the reports / image by yourself at the right side of the query page, please utilize that so that I can answer your queries better.

Wishing you good health...
Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
Follow-up: Met with an accident. MRI showed avulsion of greater tuberosity of humerus. Do I need surgery? 17 hours later
Thanks for replying,
I'm not sure what the displacement amount is exactly, but I have posted up a few stills from my MRI scan which might help.
Answered by Dr. Saurabh Gupta 15 hours later
Thanks for posting your query,

I am gone through the reports provided by you.Correct course of treatment initialy should be operative management by pin fixation. The best thing you can do right now is good physical therapy.With good physical therapy you can regain your strength back.So consult a phyisical therpist and do exersises under his/her guidence.

Hope this will help you.

Wishing you speedy recovery.

Dr Saurabh Gupta.
Orthopaedic Surgeon.
Above answer was peer-reviewed by
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