title: Remodeling of birth fractures of the humeral diaphysis.
abstract: BACKGROUND
  Birth fractures of the humeral diaphysis are encountered at most pediatric medical centers and pediatric orthopaedic practices. The treatment strategy of these fractures is uniformly nonoperative. However, we have not found sufficient studies in the literature demonstrating the extent to which remodeling is possible and therefore how much deformity is acceptable in the treatment of these fractures.
  
  
  METHODS
  We reviewed the records of our institution's Orthopaedic Surgery Clinic and identified all children seen for birth fractures of the humerus from 2001 to 2005. The angulation and displacement at presentation and at follow-up were measured.
  
  
  RESULTS
  All patients were treated nonoperatively, and most were managed by swaddling. In 9 patients with more than 4 months of radiographic follow-up, the mean initial angulation was 26 degrees in the coronal plane and 25 degrees in the sagittal plane. The mean angulation at final follow-up was 5 degrees in the coronal plane and 7 degrees in the sagittal plane. The maximum angulation at presentation was 66 degrees, which remodeled to 5 degrees at 7.3 months' follow-up.
  
  
  CONCLUSIONS
  Our findings suggest that attempts to obtain an anatomical reduction or the use of more than the simplest immobilization methods are not necessary given the tremendous capacity for remodeling of these fractures in infants.
authors.affiliation: Department of Orthopaedic Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
authors.forename: Sohail N
authors.initials: SN
authors.lastname: Husain
authors.forename: Erik C
authors.initials: EC
authors.lastname: King
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Young
authors.forename: John F
authors.initials: JF
authors.lastname: Sarwark
mesh_terms: D018483:Diaphyses / Q000000981:diagnostic imaging / Q000293:injuries*; D016267:External Fixators; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D006810:Humeral Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D007231:Infant, Newborn; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome