CPT® Code 23630

An open treatment of a greater humeral tuberosity fracture involves a surgical procedure aimed at correcting an isolated fracture of the greater tuberosity of the humerus, which is the bony prominence located at the upper end of the arm bone. This procedure includes the use of internal fixation techniques when necessary to stabilize the fracture. Isolated fractures of the greater tuberosity are uncommon and often occur alongside injuries to the rotator cuff, particularly tears between the supraspinatus and subscapularis tendons. The surgical approach taken during the procedure is determined by the specific characteristics of the fracture and the associated injuries. For smaller fractures, which may result from the avulsion of the supraspinatus tendon, a surgical approach from the anterosuperior aspect is typically utilized. In cases of larger fractures, an incision may be made over the anterior or anteroinferior shoulder to provide adequate access. The deltoid muscle, which covers the shoulder, is carefully split to expose the greater tuberosity and allow for proper identification and treatment of the fracture site. The procedure may involve debridement of the fracture site, realignment of the bone fragment, and stabilization using heavy nonabsorbable sutures or internal fixation devices such as wires or cancellous lag screws with washers. In instances where the fracture is more extensive, a deltopectoral approach may be necessary to facilitate the placement of fixation devices. Additionally, if there is any damage to the rotator cuff, it is addressed and repaired during the same surgical intervention.