Treatment of isolated greater tuberosity fractures: a scoping review
Bibliographic record
Abstract
Background: There are no evidence-based guidelines to support the management of isolated greater tuberosity fractures. While the choice between nonoperative and operative treatment is generally based on the degree of fracture displacement, the definition of an acceptable displacement continues to be debated. Consequently, the ideal management of these fractures can be a therapeutic challenge. The objective of this study was to create an overview of the literature investigating the treatment of isolated greater tuberosity fractures. Methods: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension guidelines for scoping reviews (PRISMA-ScR). Electronic databases MEDLINE, EMBASE, SPORTDiscus, and CINAHL were systematically searched from inception to September 29, 2024. Original studies investigating the treatment of isolated greater tuberosity fractures were eligible for inclusion. Screening of studies was independently performed by 3 reviewers. Data items were extracted using a standardized charting form. Risk of bias of the included studies was assessed by 2 independent reviewers using the Newcastle-Ottawa Quality Assessment Scale. Results: 3.788 records were identified in the search, 296 were retrieved for full-text screening, of which 59 were included. No randomized controlled trials were identified. 88% of the included studies were retrospective and 98% had a moderate or high risk of bias. Most of the included studies investigated operative treatment of displaced fractures (defined as >5 mm) in patient populations with a mean age between 40 and 60 years. Few studies investigated nonoperative treatment and treatment in young (<40 years) or elderly (>60 years) patients. Detailed fracture characteristics were not consistently reported. Accordingly, the size of the fragment was reported in 8% of the included studies, fractures were subclassified into avulsion, split or depression type in 29% of the included studies, and the direction of fragment displacement was reported in 34% of the included studies. Conclusion: The literature regarding the treatment of isolated greater tuberosity fractures is comprised of studies with a moderate to high risk of bias and a lack of randomized controlled trials. A 5 mm fracture displacement threshold is often used to guide treatment, though it has not been validated in clinical studies. High-quality studies are needed to establish evidence-based guidelines and improve clinical decision-making.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.007 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".