Citation, DOI, disclosures and article data
Citation:
Nicoletti D, Elfeky M, Knipe H, et al. Mutch classification of greater tuberosity fractures. Reference article, Radiopaedia.org (Accessed on 24 Jan 2025) https://doi.org/10.53347/rID-169908
The Mutch classification is a system used to classify isolated greater tuberosity fractures and has important therapeutic implications. It is considered reliable for isolated greater tuberosity fractures but is less reliable in multi-part proximal humeral fractures 4.
The Mutch classification system divides greater tuberosity fractures into three types 2:
type 1: avulsion fracture involve a small fragment of bone and the fracture line is horizontal
type 2: split fracture involves a large fragment with a vertical fracture line
type 3: depressed fracture involves a fragment that is displaced inferiorly, the fragments are impacted into the humeral head and are generally nondisplaced
History and etymology
Jennifer Mutch et al proposed this classification system into three types in 2014 2.
Fragments of the greater tuberosity with the rotator cuff attached characteristically have a longitudinal tear in the cuff between the supraspinatus and subscapularis tendons.
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1. Liu G, Guo X, Zhao Q et al. A New Biomechanical Classification System for Split Fractures of the Humeral Greater Tuberosity: Guidelines for Surgical Treatment. J Orthop Surg Res. 2021;16(1):692. doi:10.1186/s13018-021-02839-y - Pubmed
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2. Mutch J, Laflamme G, Hagemeister N, Cikes A, Rouleau D. A New Morphological Classification for Greater Tuberosity Fractures of the Proximal Humerus. The Bone & Joint Journal. 2014;96-B(5):646-51. doi:10.1302/0301-620x.96b5.32362 - Pubmed
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3. Rouleau D, Mutch J, Laflamme G. Surgical Treatment of Displaced Greater Tuberosity Fractures of the Humerus. J Am Acad Orthop Surg. 2016;24(1):46-56. doi:10.5435/jaaos-d-14-00289 - Pubmed
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4. Razaeian S, Askittou S, Wiese B et al. Inter- and Intraobserver Reliability of Morphological Mutch Classification for Greater Tuberosity Fractures of the Proximal Humerus: A Comparison of X-Ray, Two-, and Three-Dimensional CT Imaging. PLoS One. 2021;16(11):e0259646. doi:10.1371/journal.pone.0259646 - Pubmed
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