title: Centromedullary manipulation and stabilization of completely displaced proximal humerus fractures in adolescents.
abstract: Completely displaced metaphyseal fractures of the proximal humerus in older children may need reduction and stabilization. The authors describe a technique for closed reduction and intramedullary stabilization of these fractures using a centromedullary pin inserted from the distal humerus through a small distal incision. This technique was used successfully in 2 adolescents. Retrograde elastic nails avoid scars in front of the shoulder, impingement problems from prominent extramedullary metal work, and further surgery of a similar magnitude to remove the metalwork. Based on the authors' experience, they recommend this method for reduction and stabilization of displaced irreducible metaphyseal fractures of the proximal humerus in older children and adolescents.
authors.affiliation: Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom. bijusankar@doctors.org.uk
authors.forename: Biju
authors.initials: B
authors.lastname: Sankar
authors.forename: Simon
authors.initials: S
authors.lastname: Nicholson
authors.forename: Philip David
authors.initials: PD
authors.lastname: Henman
mesh_terms: D000293:Adolescent; D003131:Combined Modality Therapy; D005260:Female; D005594:Fracture Fixation, Intramedullary / Q000295:instrumentation* / Q000379:methods*; D017759:Fractures, Malunited / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D008297:Male; D026201:Musculoskeletal Manipulations / Q000379:methods*; D011859:Radiography; D012784:Shoulder Fractures / Q000000981:diagnostic imaging* / Q000628:therapy*; D016896:Treatment Outcome