4.2 Article

Proximal Humerus Fractures in the Pediatric Population

Journal

CURRENT REVIEWS IN MUSCULOSKELETAL MEDICINE
Volume 14, Issue 6, Pages 413-420

Publisher

SPRINGER
DOI: 10.1007/s12178-021-09725-4

Keywords

Pediatric proximal humerus fractures; Pediatric trauma; Proximal humerus fracture treatment; Shoulder injury; Pediatric fractures

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The treatment of proximal humerus fractures depends on the patient's age, fracture displacement, and remodeling capacity, with different treatment options for different individuals. Understanding the anatomy of the proximal humerus is crucial in guiding the proper management of these fractures.
Purpose of Review The purpose of this review is to review recent literature focusing on proximal humerus anatomy, epidemiology of these fractures, diagnosis and treatment options, and clinical outcomes. Recent Findings Non- or minimally displaced proximal humerus fractures treated nonoperatively do not lead to short- or long-term complication and do not cross over to operative treatment. There is a higher rate of operative management with older age, increased injury severity score, treatment at an adult hospital, and private insurance. Operative management is preferred with closed or open reduction and percutaneous pinning, but elastic nailing and plate fixation are other options with good postoperative outcomes. Pediatric proximal humerus fractures occur after fall onto the affected shoulder or arm. Diagnosis is usually made with radiographs. Understanding the proximal humerus anatomy is critical to the proper management of these injuries to aid reduction and predict remodeling potential. There is considerable debate around the management of proximal humerus fractures in the pediatric population. Treatment is based on patient age, fracture displacement, and remodeling capacity. Nonoperative management is successful in younger patients or less displaced fractures, and operative management is usually considered in older patients with more displaced fractures.

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