title: Salter-Harris type II proximal humerus injuries: state-of-the-art treatment.
abstract: Proximal epiphyseal injuries of the humerus represent a very low percentage of traumatic growth pathologies, 5 % of all fractures during childhood. In the literature, there have been only a limited number of clinical studies investigating these injuries, basically from an epidemiological point of view, focusing on the incidence of the different types of fractures. We report our experience of 6 young patients with Salter-Harris type II proximal humerus epiphyseal injuries adopting a minimally invasive surgical technique consisting of closed reduction and percutaneous fixation with Kirschner wires. At 2 years of follow-up, the results consisting in constant; disabilities of the arm, shoulder, and hand; simple shoulder test; and Visual Analogue Scale scores obtained have been excellent and all the patients come back to a normal life with sports practice and normal daily activities. The range of motion was completely restored without any deficit in abduction-adduction, flection-extension, or intra-extra rotation. No differences in anthropometric parameters were found with no case of malangulation, vascular, or neurological complications. Our data support with evidence how the close reduction internal fixation with K-wires treatment can give to the surgeons and the patients a better security about the correct fracture healing. Furthermore, with this article, we will provide a detailed review of the literature in order to define the state-of-the-art treatment to better face such a challenging skeletal injury.
authors.affiliation: Department of Surgical Science, Section of Orthopaedics, Traumatology and Functional Rehabilitation, U.O. Patologia dell'Apparato Locomotore, University of Parma, Via Gramsci, 14, 43100 Parma, Italy. michele.verdano@hotmail.it
authors.forename: Michele Arcangelo
authors.initials: MA
authors.lastname: Verdano
authors.forename: Andrea
authors.initials: A
authors.lastname: Pellegrini
authors.forename: Enricomaria
authors.initials: E
authors.lastname: Lunini
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Porcellini
authors.forename: Francesco
authors.initials: F
authors.lastname: Ceccarelli
mesh_terms: D000293:Adolescent; D000886:Anthropometry; D001265:Athletic Injuries / Q000601:surgery; D001642:Bicycling / Q000293:injuries; D001864:Bone Wires; D002648:Child; D003131:Combined Modality Therapy; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D007103:Immobilization; D015994:Incidence; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011859:Radiography; D016059:Range of Motion, Articular; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery* / Q000628:therapy; D016896:Treatment Outcome