Glenohumeral joint dislocation is rare in children with proximal humeral fractures: a descriptive study and literature review

Hong, Pan; Rai, Saroj; Liu, Ruikang; Tang, Xin; Li, Jin

doi:10.1186/s12891-021-04992-1

Cited by 2 publications

(3 citation statements)

References 29 publications

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“…EF has been reported to be a valuable treatment option for PHFs in children. 12,13 The complication rate and revision rate are acceptable. 14,15 The first choice for a pediatric clavicle fracture is a conservative approach.…”

Section: Discussion Of Different Surgical Managementmentioning

confidence: 97%

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A Rare Combined Injury in Children during Side Impact: The Possible Mechanism and Treatment Results

Liu,

OuYang,

et al. 2023

Orthopaedic Surgery

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ObjectiveProximal humeral fracture combined with contralateral midshaft clavicle fracture is an extremely rare injury in children. Few studies focus on the injury mechanism and treatment scheme. The aim of this study is to propose the possible mechanism of this injury and present the treatment results.MethodsThis retrospective study included children diagnosed with proximal humeral fractures combined with contralateral midshaft clavicle fractures from August 2016 to March 2019 in the corresponding author's institution. The patients received elastic stable intramedullary nails and external fixation as treatment. The radiological and clinical outcomes of treatments were evaluated using the imaging and the Constant–Murley score (CMS) in follow up.ResultsTwelve patients (eight males and four females) with an average age of 7.83 years old (age 5–12) were included in this research. All the patients had suffered a side impact in a road traffic accident or outdoor environment. Hypothesis about the mechanism was the proximal humerus was directly impacted at first and caused the surgical neck fracture, then the contralateral shoulder hits the solid object and the contralateral midshaft clavicle was fractured. During the average 45.2 months (range 36–57) follow‐up, all the patient's fractures achieved clinical and radiological union before 14 weeks without complications. Every patient had a satisfactory score (range from 92 to 100) on the CMS criteria for both shoulders.ConclusionThe hypothesis about the mechanism of this combined injury in this study sounds reasonable. It highlights the need for safety‐related education about using a safety seat or wearing a seat belt to parents and caregivers, so as to avoid such injury even if the treatment with external fixation (EF) and proximal humeral and elastic stable intramedullary nailing (ESIN) showed good results.

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Section: Discussion Of Different Surgical Managementmentioning

confidence: 97%

“…EF has been reported to be a valuable treatment option for PHFs in children 12,13 . The complication rate and revision rate are acceptable 14,15 .…”

Section: Discussionmentioning

confidence: 99%

A Rare Combined Injury in Children during Side Impact: The Possible Mechanism and Treatment Results

Liu,

OuYang,

et al. 2023

Orthopaedic Surgery

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“…47 The use of external fixators is reserved for rare cases of glenohumeral dislocation, which occurs in 2% of pediatric proximal humerus fractures. 48…”

Section: Skeletal Stabilization Techniquesmentioning

confidence: 99%

Management of Pediatric Proximal Humerus Fractures

Kim¹,

Chi²,

Niknam³

et al. 2023

Journal of the Pediatric Orthopaedic Society of North America

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Proximal humerus fractures have an outstanding potential to remodel due to their proximity to the proximal humeral physis. Fractures in young children can be treated nonoperatively with excellent outcomes. The incidence peaks in adolescent patients and these injuries most commonly occur after a fall or direct trauma. The muscle attachments of the proximal humerus act as deforming forces and anatomic structures such as the periosteum and biceps tendon may act as blocks to reduction. Operative management is uniformly indicated for patients with open fractures, ipsilateral elbow or forearm injury, associated neurovascular injury, or poly-trauma patients. Operative treatment may be further considered in older children with minimal growth remaining and with fractures that are considered significantly displaced by available classification systems. Unfortunately, there are significant challenges in recommending treatment based on displacement and age alone. The purpose of this paper is to review what is known about these injuries and how they can be treated in light of current deficiencies in the literature; this may stimulate further work to refine indications for treatment based upon age and displacement. Key Concepts• The proximal humerus physis is responsible for 80% of the growth of the entire bone, and proximal humerus fractures have tremendous potential to remodel.• Proximal humerus fractures occur most commonly due to a fall or direct trauma but other causes include overuse injury and pathologic lesions.• Treatment indications for pediatric proximal fractures are guided by age of the patient, fracture displacement, and associated injuries; the majority of these injuries may be treated nonoperatively.• Outcomes after operative and nonoperative management of proximal humerus fractures are generally good.

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Glenohumeral joint dislocation is rare in children with proximal humeral fractures: a descriptive study and literature review

Cited by 2 publications

References 29 publications

A Rare Combined Injury in Children during Side Impact: The Possible Mechanism and Treatment Results

A Rare Combined Injury in Children during Side Impact: The Possible Mechanism and Treatment Results

Management of Pediatric Proximal Humerus Fractures

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