White Eric A, Skalski Matthew R, Patel Dakshesh B, Gross Jordan S, Tomasian Anderanik, Heckmann Nathanael, Matcuk George R
Keck School of Medicine at the University of Southern California, Los Angeles, CA, USA.
Emerg Radiol. 2018 Jun;25(3):235-246. doi: 10.1007/s10140-018-1589-8. Epub 2018 Feb 16.
The greater tuberosity is an important anatomic structure and its integrity is important for shoulder abduction and external rotation. Isolated fractures of the greater tuberosity are often subtle and may not be detected on initial radiographs. Clinically, these patients display symptoms which mimic a full thickness rotator cuff tear. It is important to differentiate these two entities, as their treatment is different (typically nonsurgical management for minimally displaced fractures versus rotator cuff repair for acute full thickness rotator cuff tears). When greater tuberosity fractures are significantly displaced and allowed to heal without anatomic reduction, they can lead to impingement. This article will review greater tuberosity anatomy and function, as well as the clinical presentation and multimodality imaging findings of greater tuberosity fractures. Imaging optimization, pitfalls, and clinical management of these fractures will also be discussed.
大结节是一个重要的解剖结构，其完整性对于肩关节外展和外旋很重要。大结节的孤立性骨折通常很细微，在最初的X线片上可能无法检测到。临床上，这些患者表现出的症状类似于全层肩袖撕裂。区分这两种情况很重要，因为它们的治疗方法不同（对于轻度移位骨折通常采用非手术治疗，而对于急性全层肩袖撕裂则进行肩袖修复）。当大结节骨折明显移位且未经解剖复位就愈合时，可能会导致撞击。本文将回顾大结节的解剖结构和功能，以及大结节骨折的临床表现和多模态影像学表现。还将讨论这些骨折的影像学优化、陷阱及临床处理。
