Fractures Involving the Proximal Humeral Epiphyseal Plate

Fractures of the proximal humerus in children: Nine-year follow-up of 64 unoperated on cases

“…The satisfactory final result in our series accords with other similar studies (Wahl (1982), Dameron and Reibel (1969), Hohl (1976), Nilsson and Svartholm (196.5), Kohler and Trilland (1983), Ansorg and Graner (1978). The good prognosis of this fracture in spite of initially severe dislocation can partly be explained by the great mobility of the glenohumeral joint.…”

“…Most earlier studies are hampered by lack of accuracy in the classification of the fractures, although this has been shown important in evaluating late results (Neer and Horwitz 1965). The most frequent complications are claimed to be angulation and shortening (Dameron and Reibel 1969).…”

Physeal injuries of the proximal humerus: long-term results in seventy two patients

“…This indicates that under the age of ten years angulations up to 20°may be tolerated. According to Dameron and Reibel [11] and Rockwood et al [19] angulations up to 70°from one to five years of age and 40°f rom five to 12 years are tolerated.…”

“…This explains the typical fracture types. Isolated epiphyseal separation is rare and occurs typically in newborns and toddlers [11,12]. Because of the high potential of spontaneous correction due to the proximal humeral epiphysis the prognosis of proximal humerus fractures is good.…”

“…Beyond the age of 12 years the correction ability shrinks to half of the primary malposition, which can be tolerated to a maximum of 40 degrees of correction [13]. The most frequent and major complications in children and adolescents are limb-length discrepancy [11] and varus deformity [14] which often lead to a decrease of range of motion-mainly abduction. In many cases this restriction remains for the rest of the patient"s lifetime [15].…”