Management of Pediatric Proximal Humerus Fractures Current Concept Review

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Arin E. Kim
Hannah Chi
Kian Niknam
Ishaan Swarup


Proximal humerus fractures are commonly seen by orthopaedic providers. Its 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. These injuries are often classified using the Neer-Horowitz classification system or the Salter-Harris classification system. The Neer-Horowitz classification helps to guide treatment since it is based on displacement, and it is commonly used in the literature. These fractures have an outstanding potential to remodel due to their proximity to the proximal humeral physis. The majority of fractures in young children can be treated nonoperatively with excellent outcomes. Operative management may be considered in older children with displaced fractures, and patients with open fractures, associated neurovascular injury or poly-trauma patients. The most common techniques for fixation include the use of percutaneous fixation and elastic nailing. In general, patients have good outcomes with operative and nonoperative management of proximal humerus fractures.

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How to Cite
Kim, A. E., Chi, H., Niknam, K., & Swarup, I. (2023). Management of Pediatric Proximal Humerus Fractures: Current Concept Review. Journal of the Pediatric Orthopaedic Society of North America, 5(1).