Proximal humerus fracture (peds): Difference between revisions
(Text replacement - "r/o" to "rule out") |
ClaireLewis (talk | contribs) |
||
| (3 intermediate revisions by 3 users not shown) | |||
| Line 1: | Line 1: | ||
==Background == | ''This page is for <u>pediatric</u> patients; for adult patients see [[proximal humerus fracture]]'' | ||
==Background== | |||
*Occurs predominantly during adolescence | *Occurs predominantly during adolescence | ||
*Proximal fractures classified using the Neer classification system based on number of component fractures | *Proximal fractures classified using the Neer classification system based on number of component fractures | ||
| Line 10: | Line 11: | ||
==Evaluation== | ==Evaluation== | ||
*XR AP Lateral, scapular Y - asses fracture and rule out dislocation | *XR AP Lateral, scapular Y - asses fracture and rule out [[shoulder dislocation|dislocation]] | ||
* | *[[Ultrasound]] may be used in newborns before ossification centers present | ||
== | ==Management== | ||
*Depends on the age of the child and degree of displacement | *Depends on the age of the child and degree of displacement | ||
'''Non-Operative''' | '''Non-Operative''' | ||
| Line 29: | Line 30: | ||
*Intraarticular fracture | *Intraarticular fracture | ||
==Disposition == | ==Disposition== | ||
*Slightly displaced fracture: Sling and ortho follow up | *Slightly displaced fracture: Sling and ortho follow up | ||
*Displaced >30 degrees: may need closed reduction | *Displaced >30 degrees: may need closed reduction | ||
Latest revision as of 18:01, 28 September 2019
This page is for pediatric patients; for adult patients see proximal humerus fracture
Background
- Occurs predominantly during adolescence
- Proximal fractures classified using the Neer classification system based on number of component fractures
Clinical Features
Differential Diagnosis
Humerus Fracture Types
Evaluation
- XR AP Lateral, scapular Y - asses fracture and rule out dislocation
- Ultrasound may be used in newborns before ossification centers present
Management
- Depends on the age of the child and degree of displacement
Non-Operative
- For almost all children, will approach non-operatively
- Excellent remodeling ability of bone and ROM to shoulder
- Ortho consult is needed to determine the best approach
- Sling and swathe splint, or coaptation splint
- Gentle ROM in 1-2 weeks as tolerated
Operative Indications
- More than 45 degrees of angulation
- Less than 50% apposition of proximal humerus and shaft
- Open fractures
- Neurovascular injury
- Intraarticular fracture
Disposition
- Slightly displaced fracture: Sling and ortho follow up
- Displaced >30 degrees: may need closed reduction
See Also
References
- Harwood Nuss
- Orthobullets