ال greater tubercle is the conspicuous zone of bone at the highest point of the humerus and is the connection between the two vast, intense rotator sleeve muscles-supraspinatus and infraspinatus.
It is harmed/broken in a fall by either landing specifically on the side of your shoulder or arriving with your arm outstretched. It might break alone or with different wounds of the shoulder joint (normally a shoulder disengagement or complex humeral crack).
بطريقة مماثلة, with most cracks, it might be displaced (out of its typical position) or undisplaced.
Undisplaced Greater Tubercle Fracture
I call this the ‘concealed fracture‘ as an undisplaced break of the more prominent tuberosity is normal and frequently does not appear on x-beams. It is basic for individuals to harm their shoulder and x-beams look ordinary. This is every now and again found in skiing and mountain biking wounds. An analysis of ‘bear sprain’ or deltoid damage or rotator sleeve damage is given and rest, restoration and painkillers prescribed.
In the event that your shoulder damage isn’t settling in fourteen days after a fall and x-beams are typical, at that point you should speculate a more prominent tuberosity crack. It can be effortlessly observed on an MRI exam and furthermore for the most part on an ultrasound output of the shoulder.
Surgery isn’t required for an undisplaced crack. ومع ذلك, these moderately minor breaks can set aside a long opportunity to mend and for the torment to settle. Shoulder solidness and solidified shoulder are likewise visiting after an undisplaced more prominent tubercle crack. This may require treatment, similar to a genuine solidified shoulder. Now and again it can take up to one year to completely recuperate.
Displaced Greater Tubercle Fracture
Secluded displaced greater tubercle breaks are thought to happen in fewer than 2% of proximal humeral cracks and are regularly connected with front shoulder disengagements. The more prominent tubercle part segregates with its connected rotator sleeve and will naturally have a longitudinal tear in the sleeve between the supraspinatus and تحت الكتف الأربطة. The more noteworthy tubercle piece is pulled superiorly by the supraspinatus and posteriorly by infraspinatus and teres minor.
علاج او معاملة
As more prominent greater tubercle breaks are generally withdrawn posteriorly and superiorly, a shut lessening is troublesome. On the off chance that left in position, impingement will create against the acromion, constraining rise and outer revolution of the shoulder. Notwithstanding if the crack is related to foremost separation then a shut diminishment of the glen humeral disengagement may effectively decrease the more noteworthy tuberosity break, and once it has recuperated, repetitive front unsteadiness is impossible.
The surgical way to deal with this break is much similar to a rotator sleeve repair, anterosuperiorly, regularly entire with an acromioplasty. An elective approach is a deltoid-part approach. ومع ذلك, as opposed to taking the deltoid off the front acromion, it is peeled off the back acromion which dodges the acromioplasty and limits debilitating of the foremost deltoid. This approach is especially useful if the section is uprooted posteriorly. The obsession of little cracks can be proficient with substantial sutures, wire or at times, screws. Rotator sleeve tears related to the crack are additionally shut. On the off chance on account of an expansive more prominent tuberosity crack, a deltopectoral approach would consider more satisfactory introduction for the decrease and legitimate obsession.