Avulsion of the lesser tuberosity with a Salter-Harris type II injury of the proximal humerus: A case report

Lesser Tuberosity Avulsions in Adolescents

“…1c), in contrast to osteochondroma which is continuous with the medullary canal [17]. In addition to the two patients reported here, this type of presentation, mistaken for an osteochondroma, has been reported in three previous case reports and two of our patients [9, 22, 29].…”

“…Subscapularis tendon osseous avulsions are rare [19] and are often overlooked [14]. Most of the lesser tuberosity fractures described in the literature present as chronic injuries, diagnosed several months after the traumatic event [4, 15, 19, 20, 29, 33]. This is usually a result of the lack of recognition of this clinical problem as well as misinterpretation of conventional radiography.…”

“…These injuries are known to be associated with avulsion fracture of the lesser tuberosity, for which treatment has traditionally included either physical therapy or open reduction and internal fixation [14]. Isolated avulsion injuries of the lesser tuberosity tend to occur in two populations—adolescents and middle-aged men [8, 15, 19, 27, 29]. In the current literature, there are reports on 80 cases of isolated fractures of the lesser tuberosity [1, 3, 4, 6, 8, 9, 15, 16, 18–20, 26, 28–30, 32].…”

Lesser Tuberosity Avulsion Fracture in an 11-Year-Old Baseball Player due to Batting

“…Despite these injuries being readily identified on magnetic resonance imaging (MRI), the varying clinical presentations associated with this injury can make it difficult to determine whether MRI or further workup is required [ 1 , 2 ]. As a result, these injuries are commonly misdiagnosed as strains and are discovered weeks to months after the initial incident [ 2 , 8 , 17 – 20 ]. Understanding the various mechanisms of injury allows for a better understanding of patient presentations, prevents prolonged shoulder impairment, and enables a quicker return to activity.…”