Humeral Shaft Fractures in Children – Incidence, Management and Treatment Effects

Abstract

Background. Humeral shaft fractures are relatively rare in children, with incidence between 0.4% and 3% of all fractures in children and between 10% and 20% of all humeral fractures. The purpose of our study was to retrospectively evaluate all humeral shaft fractures treated at children's trauma center from january 2012 till december 2021. Material and methods. We retrospectively evaluated the group of 104 skeletally immature patients with humeral shaft fracture treated in our hospital. We have analyzed: age; sex; fracture type, management; time of bone healing; final effect and complications. Results. The non-surgical group consisted of 73 patients (27 girls and 46 boys) with an average age of 8.03 (0.6 - 17.7), while the surgical group consisted of 31 patients (16 girls and 15 boys) with an average age of 12.47 (5,7- 17.8). The mean follow-up was 7.65 months (4-12) in non-surgical group, and 13.38 months (4-24) in surgical group. We have analyzed the results statistically, confirming increase the frequency of the above-mentioned fractures and increase the number of patients treated with surgery. We achieved good effect in all patients. Conclusions. 1. Humeral shaft fractures in children are relatively rare. Although in recent years, we have observed an increase of their frequency; 2. The vast majority of humeral shaft fractures are treated non-surgically with good clinical results; 3. Increase of number of patients treated surgically has been noticeable in the last decade; 4. Surgery is associated with a relatively low risk of complications and allows for cast withdrawal, which significantly improves the patients comfort.

Case report: Pediatric floating elbow fracture with monteggia-equivalent lesion, ipsilateral humeral shaft fracture, and radial nerve injury: a unique case and favorable treatment outcomes

“…Stanitski and Micheli introduced the term “floating elbow” to describe a forearm and humerus fracture in the same limb ( 4 ). Pediatric humeral shaft fracture incidence rates range from 12 to 30 cases per 100,000 individuals, accounting for approximately 20% of all humeral fractures in children ( 2 ). Monteggia fracture equivalent incidence rates remain undetermined due to subtype variety and overall rarity.…”

“…Metaizeau's introduction of elastic intramedullary nailing in the 1980s made it one of the standard methods for treating pediatric long bone fractures ( 7 ). The flexible intramedullary nailing (FIN) system is commonly used to treat humeral shaft fractures, stabilizing the fracture by applying a three-point balanced force within the medullary cavity ( 2 , 8 ). Similarly, the elastic intramedullary nail has been widely recognized for treating forearm fractures due to its advantages, including minimal trauma, simple operation, preservation of blood supply, fewer complications, and faster recovery ( 2 , 9 ).…”

“…The flexible intramedullary nailing (FIN) system is commonly used to treat humeral shaft fractures, stabilizing the fracture by applying a three-point balanced force within the medullary cavity ( 2 , 8 ). Similarly, the elastic intramedullary nail has been widely recognized for treating forearm fractures due to its advantages, including minimal trauma, simple operation, preservation of blood supply, fewer complications, and faster recovery ( 2 , 9 ). Our case presented a significant challenge, as the patient had two fractures in the radius.…”

“…Predominantly, research targets supracondylar humeral fractures in conjunction with forearm fractures ( 1 ). Pediatric humeral shaft fractures represent a mere 1%–3% of all fractures in children and less than 10% of all humeral fractures within this demographic ( 2 ). Monteggia fractures, severe elbow joint fractures in pediatric patients, pose considerable management challenges and are frequently accompanied by complications.…”

Application Value of Sevoflurane Combined with Brachial Plexus Block in Children with Humeral Fracture Surgery and its Effect on Hemodynamics: A Clinical and Anatomical Study

“…Children with minor fracture symptoms may receive conservative treatment in a clinic setting. If conservative treatment fails, reduction and fixation of children with fracture through surgery is a common treatment method (Wiktor & Tomaszewski, 2022). However, because of children's immature physical and psychological development, the procedure is invasive, which results in the behavior of sobbing and anxiety in children who have fractures, as well as limited cooperation and low tolerance, which subsequently interferes with the procedure's smooth progression (Wu, 2020).…”