Evaluation and Management of Pediatric Humeral Shaft Fractures

Diaphyseal humerus fractures in the pediatric population have dynamic treatment strategies that depend on injury pattern, mechanism, patient skeletal maturity, and size. Treatment strategies include closed reduction with various immobilization techniques, flexible nails, uniplanar or multiplanar external fixation, or plate osteosynthesis. Accepted parameters for sagittal and coronal alignment vary based on age and potential for remodeling, and the multiplanar motion of the shoulder joint can accommodate for greater variations in alignment than many other long bone fractures. Complications such as radial nerve palsy are possible with both open and closed injuries, and mal/nonunions, although rare, can occur. Overall, treatment should be predicated on a full evaluation of the patient, fracture, local soft tissues, and any concomitant injuries.

Automated summary

The treatment strategies for diaphyseal humerus fractures in the pediatric population depend on various factors such as injury pattern, mechanism, skeletal maturity, and size. Treatment options include closed reduction with immobilization techniques, flexible nails, external fixation, or plate osteosynthesis. Alignment parameters vary based on age and potential for remodeling, and the shoulder joint's multiplanar motion allows for greater variations in alignment compared to other long bone fractures. Complications like radial nerve palsy and mal/nonunions can occur. Comprehensive evaluation of the patient, fracture, local soft tissues, and concomitant injuries should guide treatment decisions.