title: Displaced fractures of the proximal humerus in children require open/closed reduction and internal fixation.
abstract: Fractures of the proximal humerus in children are rare and constitute only 3% of all epiphyseal injuries. From 1992 to 2002 sixteen patients aged 4 - 15 years with a displaced fracture of the proximal humerus were treated at our level I trauma unit. The mean follow-up of the patients was 23.8 months (8 - 72). Ten children had a metaphyseal fracture and six a Salter and Harris Type II injury. Only one metaphyseal fracture was treated conservatively; the other patients underwent surgery (ORIF [= open reduction internal fixation] in ten patients, CRIF [= closed reduction internal fixation] in five patients). Follow-up examination showed no shortening or major angulation of the humerus in any of the sixteen cases. Fifteen children showed excellent and good results. There was only one average result in a polytraumatized child with additional injuries in both upper extremities. Based on the results of this study we suggest performing ORIF/CRIF in displaced fractures of the proximal humerus in children.
authors.affiliation: Department of Traumatology, University of Vienna Medical School, Vienna, Austria. elisabeth.schwendenwein@akh-wien.ac.at
authors.forename: E
authors.initials: E
authors.lastname: Schwendenwein
authors.forename: S
authors.initials: S
authors.lastname: Hajdu
authors.forename: C
authors.initials: C
authors.lastname: Gaebler
authors.forename: K
authors.initials: K
authors.lastname: Stengg
authors.forename: V
authors.initials: V
authors.lastname: Vécsei
mesh_terms: D002648:Child; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D011859:Radiography; D012189:Retrospective Studies; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors