title: Epiphyseal separation of the proximal humerus after birth trauma.
abstract: The purpose of this study was to report a new entity of epiphyseal slipping, which is a slipping of the upper humeral epiphysis in neonates due to birth trauma, and reporting the results of their management. Eight neonates presented with pseudo-paralysis with associated shoulder swelling and pain on passive movements of the upper limb; the radiographs revealed slipping of the proximal humeral epiphyses in six cases and associated shoulder dislocations in the other 2 cases. Failed attempts of closed reduction were done for all cases; they were managed through open reduction of the slipping and relocation of the glenohumeral joint when dislocated. The deltopectoral approach was used for management, and the slipping was fixed with k-wires through the skin. A full painless range of motion of the shoulder was achieved in all patients; no limb-length discrepancy or deformity was detected and no recurrent shoulder dislocation. In the last follow-up, all radiographs showed an anatomic reduction of the epiphyses, and all the epiphyseal plates were open. All cases showed normally growing well-formed epiphyses with no evidence of a vascular necrosis or collapse. A new entity of epiphyseal slipping was reported in this study; slipping of the upper humeral epiphysis in neonates due to birth trauma whether it is associated with shoulder dislocation or not is a benign injury with excellent results with open reduction.
authors.affiliation: Orthopedic Department 2, Mansoura University Hospitals, Mansoura, Egypt, waelalimaher@gmail.com.
authors.forename: Wael A
authors.initials: WA
authors.lastname: El-Adl
authors.forename: Hatem S A
authors.initials: HS
authors.lastname: Elgohary
authors.forename: Maged M
authors.initials: MM
authors.lastname: Elshennawy
mesh_terms: D001720:Birth Injuries / Q000000981:diagnostic imaging / Q000601:surgery*; D001864:Bone Wires; D004839:Epiphyses, Slipped / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D006811:Humerus / Q000000981:diagnostic imaging / Q000293:injuries*; D007231:Infant, Newborn; D008297:Male; D011859:Radiography; D016059:Range of Motion, Articular; D012783:Shoulder Dislocation / Q000000981:diagnostic imaging / Q000601:surgery*