Fractures of the proximal humerus in children.
Ninety-one children who had been treated for fractures of the proximal humerus (59 metaphyseal fractures; 32 epiphyseal fractures) from 1980 to 1992 at an average age of 10.7 years (range 3 to 14 years) were reviewed. In 82 cases a nonsurgical treatment (Desault bandage in 11 cases, hanging cast in nine cases, closed reduction and shoulder spica cast in 62 cases) was performed. At a mean time of 7.2 months (range 1 to 156 months), 96% of patients showed good/excellent clinical results. In 15 cases, radiographs were reviewed at a mean follow-up of 8 years (range 1 to 23.5 years): just a slight metaphyseal or meta-diaphyseal varus deformity was found in three cases. In nine cases surgery was required. Patients were reviewed by clinical examination at a mean time of 34.8 months (1-150 months), and in six cases radiographs were reviewed at a mean time of 5 years and 5 months (range 1 to 12.5 years) after surgery. In one case, a septic process occurred, that caused a severe deformity of the epiphysis and a noticeable functional deficit. Good/excellent clinical and radiographic results were achieved in the other patients. Conservative treatment of fractures of the proximal humerus in children is recommended. Surgery should be reserved for specific cases.
Di Gennaro
Giovanni Luigi
GL
Department of Paediatric Orthopaedics and Traumatology, Istituto Ortopedico Rizzoli, Via Pupilli 1, 40136, Bologna, Italy. gianluigidigennaro@tin.it
Spina
Mauro
M
Lampasi
Manuele
M
Libri
Rolando
R
Donzelli
Onofrio
O
D000293:Adolescent; D001458:Bandages; D002370:Casts, Surgical; D002648:Child; D002675:Child, Preschool; D004838:Epiphyses / Q000293:injuries / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal; D006801:Humans; D008297:Male; D010000:Osteitis / Q000209:etiology / Q000517:prevention & control; D011183:Postoperative Complications; D011859:Radiography; D012086:Reoperation; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy