Pearls

• The rotator cuff tendons attach to the greater tuberosity. If this is a displaced fractures it becomes the equivalent of a rotator cuff injury.
• If associated with a shoulder dislocation, reduction of the shoulder can also reduce the greater tuberosity fracture.
• An isolated greater tuberosity fracture is not a contraindication to reduction of an associated shoulder dislocation, but has a <1% risk of fracture propagation.
• Obtain axillary or Velpeau X-ray to rule out concomitant shoulder dislocation.

Complications

Surgery is indicated for fractures with >5mm of displacement of the greater tuberosity.