Abstract
Fractures of the proximal humerus represent approximately 0.45% of all pediatric fractures and 4%-7% of all epiphyseal fractures. We report 2 children who underwent conservative treatment for fractures of the proximal humerus.
Case 1 : A 12-year-old girl fell from some playground equipment. Plain radiograph demonstrated fractures of the proximal humerus (Neer classification, 2-part surgical neck, and type II by the Salter-Harris classification, with more than 90 degrees of varus deformity and 80% limb-length discrepancy). She was treated conservatively with a fitted external fixation brace for 6 weeks.
After 4 months, plain radiograph demonstrated 60 degrees of varus deformity and 30% limb-length discrepancy. However, she had no disability with shoulder function.
Case 2 : A 15-year-old boy fell down from his bicycle and twisted his left shoulder. Plain radiograph demonstrated fractures of the proximal humerus (Neer classification, 2-part surgical neck, and type II by the Salter-Harris classification, with 30 degrees of varus deformity and less than 30% limb-length discrepancy. A large bone fragment was observed). He was treated conservatively with a fitted external fixation brace for 6 weeks. After 3 months, plain radiograph showed that the deformity had been corrected and that the third bone fragment had disappeared. The patient had no disability with shoulder function.
The proximal growth plate of the humerus is known to be the most active physis of the whole skelton. In most cases, proximal humerus fracture can be cured without residual disability or functional problems, and also cosmetic results are good. Remodeling potential is considerable, and is related to the age of the patient.
This report has described good result of conservative treatment for fractures of the proximal humerus in children.
