# A Case of Chronic Avulsion Fracture of the Lesser Tuberosity of the Humerus in an Adolescent

## TL;DR

A 14-year-old athlete had a rare chronic shoulder fracture misdiagnosed as a bruise, requiring surgery and imaging to fully recover.

## Contribution

Highlights the importance of advanced imaging and timely surgical intervention for rare adolescent shoulder fractures.

## Key findings

- Chronic avulsion fracture was misdiagnosed as a contusion, leading to persistent shoulder pain.
- Surgical suture bridge fixation achieved bone union and full recovery within six months.
- Standard radiographs lacked sensitivity, emphasizing the need for MRI or CT in similar cases.

## Abstract

This case report presents a rare instance of chronic avulsion fracture of the humeral lesser tuberosity in a 14-year-old male athlete. Initially misdiagnosed as a contusion, the injury resulted in persistent pain and restricted shoulder function. Advanced imaging, including CT and MRI, identified a non-union fracture. Surgical management was undertaken through a deltopectoral approach, employing suture bridge fixation with suture anchors, which secured stable fixation and achieved bone union within four months. At the six-month postoperative mark, the patient demonstrated complete recovery of shoulder strength and range of motion, resuming athletic activities without complications. This case underscores the diagnostic complexities associated with such fractures in adolescents, particularly due to the limited sensitivity of standard radiographs. Early utilization of MRI or CT imaging, alongside a suitable surgical strategy, is essential for favorable outcomes in comparable cases. This report underscores the necessity for enhanced diagnostic precision and prompt intervention in the treatment of rare adolescent shoulder fractures.