Abstract
Background: Isolated fractures of the lesser tuberosity of the humerus are exceptionally rare and often challenging to diagnose due to non-specific symptoms and their infrequent occurrence. The accurate diagnosis and timely treatment of such fractures are critical to prevent complications such as chronic shoulder pain and functional impairment.
Objective: This study aims to review the clinical presentation, diagnostic challenges, and treatment outcomes associated with isolated lesser tuberosity fractures of the humerus. Additionally, we present two case reports that highlight the surgical management of these injuries and their outcomes.
Methods: Both male patients, aged 31 and 35 sustained their injuries from falls and presented with acute shoulder pain and limited motion. Initial X-rays were inconclusive, leading to further imaging with CT scans, which confirmed the diagnosis. Both patients underwent open reduction and internal fixation (ORIF). Postoperative follow-up included serial radiographs and clinical assessment of shoulder motion.
Results: ORIF restored the lesser tuberosity to its anatomical position in both cases. Follow-up radiographs demonstrated maintained reduction and progressive union, while clinical examination showed marked improvement in pain and shoulder function. At 3 months, case 1 had mild residual limitation of abduction and extension, whereas case 2 recovered near-full shoulder motion after rehabilitation.
Conclusion: Isolated lesser tuberosity fractures, though rare, require careful clinical evaluation and imaging for accurate diagnosis. Early and accurate diagnosis of isolated lesser tuberosity fractures is crucial to prevent long-term complications. Surgical management, particularly ORIF, appears to be a reliable approach in treating these fractures, resulting in favorable outcomes. Further research is needed to establish standardized treatment protocols for these uncommon injuries
| Published | 2026-04-30 | |
| Fulltext |
|
|
| Language |
|
|
| Issue | Vol. 16 No. 02 (2026) | |
| Section | Case Reports | |
| DOI | 10.34071/jmp.2026.2.1085 | |
| Keywords | Isolated lesser tuberosity fracture, humerus, shoulder injury, open reduction internal fixation (ORIF), clinical diagnosis, fracture management |
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Copyright (c) 2026 Hue Journal of Medicine and Pharmacy
Wu GB, Wang SQ, Wen SW, Yu GR. Isolated avulsion fractures of the lesser tuberosity humerus: a case report and review of the literature. Int J Clin Exp Med. 2014.
Kotsalis G, Georgountzos A, Kechagias I, et al. Irreducible posterior shoulder dislocation with concomitant fracture of both the greater and lesser tuberosity: an extremely rare shoulder injury. Cureus. 2024;16(1):e52312.
Levine B, Pereira D, Rosen J. Avulsion fractures of the lesser tuberosity of the humerus in adolescents: review of the literature and case report. J Orthop Trauma. 2005;19(5):349-52.
Jaya TS, Hadizie D, Muzaffar TMS. Isolated avulsion fracture of the lesser tuberosity of the humerus: a rare presentation post-seizure. Trauma Cases Rev. 2019;5:078.
Harper DK, Craig JG, van Holsbeeck MT. Apophyseal injuries of the lesser tuberosity in adolescents: a series of five cases. Emerg Radiol. 2013;20:33-7.
Pace A, Ribbans W, Kim JH. Isolated lesser tuberosity fracture of the humerus. Orthopedics. 2008;31:94.
Ogawa K, Takahashi M. Long-term outcome of isolated lesser tuberosity fractures of the humerus. J Trauma. 1997;42(5):955-9.
Hung LH, Chung KY, Tang N, Leung KS. Isolated avulsion fracture of the lesser tuberosity of the humerus: case report and literature review. J Orthop Trauma Rehabil. 2012;16(2):78-81.
Gruson KI, Ruchelsman DE, Tejwani NC. Isolated tuberosity fractures of the proximal humerus: current concepts. Injury. 2008;39(3):284-98.
Park TS, Choi IY, Kim YH, Park MR, Shon JH, et al. A new suggestion for the treatment of minimally displaced fractures of the greater tuberosity of the proximal humerus. Bull Hosp Jt Dis. 1997;56:171-6.
Paschal SO, Hutton KS, Weatherall PT. Isolated avulsion fracture of the lesser tuberosity of the humerus in adolescents: a report of two cases. J Bone Joint Surg Am. 1995;77:1427-30.
Scheibel M, Martinek V, Imhoff AB. Arthroscopic reconstruction of an isolated avulsion fracture of the lesser tuberosity. Arthroscopy. 2005;21(4):487-94.
Vezeridis PS, Bae DS, Kocher MS, Kramer DE, Yen YM, Waters PM. Surgical treatment for avulsion injuries of the humeral lesser tuberosity apophysis in adolescents. J Bone Joint Surg Am. 2011;93(20):1882-8.
Vavken P, Bae DS, Waters PM, Flutie B, Kramer DE. Treating subscapularis and lesser tuberosity avulsion injuries in skeletally immature patients: a systematic review. Arthroscopy. 2016;32(5):919-28.
Cregar WM, MacLean IS, Verma NN, Trenhaile SW. Lesser tuberosity avulsion fracture repair using knotless arthroscopic fixation. Arthrosc Tech. 2018.