[Proximal humeral fractures in children: large remodeling capacity, conservative treatment]

Ned Tijdschr Geneeskd. 2021 Aug 12:165:D5420.
[Article in Dutch]

Abstract

Proximal humeral fractures affect 1.5-3% of all childhood fractures. Usually, these fractures can be treated conservatively depending on age and fracture displacement. The proximal growth plate has a great potential for remodeling. The aim of this article is to clarify which degree of displacement can be accepted in case of non-operative treatment. A 12-year-old girl and a 13-year-old boy presented at the ER after falling from a pony and a climbing frame, respectively. Both had a severely displaced proximal humeral fracture with 80-90 degrees angulation of the humeral head relative to the shaft. Both patients were treated conservatively and follow-up x-rays of the shoulder showed complete remodeling of the humeral head with full functional recovery of the shoulder. Due to the remodeling capacity the proximal humerus, severely displaced fractures in children can be treated nonoperatively in most cases. Unnecessary surgical interventions should be avoided.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Animals
  • Bone Plates
  • Child
  • Conservative Treatment
  • Female
  • Fracture Fixation, Internal
  • Horses
  • Humans
  • Humeral Fractures*
  • Humerus
  • Male
  • Shoulder Fractures* / diagnostic imaging
  • Shoulder Fractures* / therapy
  • Treatment Outcome