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What Is the Greater Tubercle?

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  • Written By: Mary McMahon
  • Edited By: Kristen Osborne
  • Last Modified Date: 20 August 2014
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The greater tubercle is an anatomical process on the humerus, a long bone of the body located in the upper arm. This structure serves as the point of insertion for several muscles in the arm and chest. It is sometimes involved in fractures, most commonly in shoulder dislocations and rotator cuff injuries. Injuries to the greater tubercle are usually treated by an orthopedic doctor, a medical specialist who focuses on caring for the skeleton.

Anatomically, the greater tubercle is positioned laterally to the humeral head, to the side of the bone. The head of the humerus inserts into the shoulder socket while the greater tubercle protrudes to the outside of the shoulder. The structure has a flattened appearance with points for the teres minor, infraspinatus, and supraspinatus muscles to attach. The surface of the structure is roughened. A corresponding structure known as the lesser tubercle forms a ridge on the inside of the humerus.

The greater tubercle is most commonly injured in shoulder injuries where the shoulder is dislocated or tremendous stress is put on the rotator cuff. A sharp blow to the shoulder can also hit this anatomical landmark, leading to a fracture. Fractures of this process are difficult to treat. They usually require surgery as it is challenging to reduce a closed fracture and it can be difficult to fix the fracture in place to allow the bone to heal.

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In surgery, a surgeon will typically use screws or pins to fix the greater tubercle in place. Casting may be used to immobilize the arm, or it may be positioned in a sling, depending on other associated injuries, as the greater tubercle is rarely fractured alone. X-rays can be used to follow up on the course of healing and to determine whether additional treatment is needed. The biggest risk with fractures of this bone is necrosis, bone death caused by inadequate blood supply.

People who experience shoulder fractures typically notice them, because the shoulder is often extremely painful, range of motion in the arm may be limited, and the shoulder can appear visibly out of position. It is important to receive prompt treatment for fractures to avoid complications like necrosis. Sometimes fractures are less obvious and the patient may think that persistent shoulder pain is being caused by a strained muscle, rather than a broken bone. If shoulder pain persists despite pain management at home, it is advisable to see a doctor for evaluation.

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kylee07drg
Post 4

@StarJo - I had nursemaid elbow as a child, and luckily, my greater tubercle was not fractured. Had it been, I’m sure that the treatment would have been much more involved.

It is a form of shoulder dislocation. So, nursemaid elbow reduction is a treatment that involves the doctor popping your arm and shoulder back into place.

My uncle had a bad habit of swinging me around by my hands. This is how I got the condition. It hurt, and I knew something was wrong right away.

The doctor held my arm straight and suddenly pushed it up with quite a bit of force. I could hear it pop back into place. I was shocked that it was so easy to treat!

StarJo
Post 3

My niece suffered from something called “nursemaid elbow” when she was a toddler. Young children are prone to greater tubercle injury, because their bodies are not fully developed.

My sister had been tugging at her daughter’s hand in an attempt to make her hurry up and get in the car. The child resisted her and wound up injuring her arm as a result.

With nursemaid elbow, there will be pain initially, but not long after it happens, the pain will go away. However, the child will not be able to use the injured arm, because when she turns her wrist to make her thumb face away from her body, there will be intense pain.

seag47
Post 2

@wavy58 - I’m sure my dad would understand your friend’s reasoning. He fractured his greater tubercle so badly that he did have to have surgery to repair it.

It had been raining for days, and his yard was muddy. He slipped and fell right on his elbow, and he heard his shoulder snap. He felt a pain so intense and unlike anything he had ever experienced.

He had to be put under anesthesia so that the doctor and nurses could put his arm back in socket. He had to have screws put inside him to hold the greater tubercle in place.

As if that weren’t enough, he had to wear a sling for weeks and have physical therapy for months. He missed an entire summer of garden work. On the bright side, he has now recovered fully.

wavy58
Post 1

I have heard that rotator cuff injuries are incredibly painful. My friend injured his while playing sports, and he said that he had to take strong pain medication for months just to deal with the suffering.

He had fractured his greater tubercle of the humerus, but the fracture wasn’t very deep. He didn’t need surgery, but he did have to wear a cast for months.

Now, he is afraid to engage in sports. He said that it just isn’t worth the risk of re-injuring his greater tubercle, and he never wants to feel that pain again.

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