Humerus fracture (peds): Difference between revisions

Latest revision as of 18:55, 22 March 2023

This page is for pediatric patients. For adult patients, see: Humerus fracture.

Background

Comminuted midshaft humeral fracture with callous formation

Humerus Fracture Types

Humeral anatomy

Adult
- Proximal
- Shaft
- Distal
Pediatric
- Proximal
- Shaft
- Distal

Clinical Features

History of trauma
Pain over fracture site

Differential Diagnosis

Shoulder and Upper Arm Diagnoses

Traumatic/Acute:

Nontraumatic/Chronic:

Refered pain & non-orthopedic causes:

Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
Brachial plexus injury
- Rucksack paralysis
Axillary artery thrombosis
Thoracic outlet syndrome
Subclavian steal syndrome
Pancoast tumor
Myocardial infarction
Pneumonia
Pulmonary embolism

Evaluation

Workup

Diagnosis

Management & Disposition

General Fracture Management

Acute pain management
Open fractures require immediate IV antibiotics and urgent surgical washout
Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
Consider risk for compartment syndrome

Pediatric Humerus Fracture Management Table

Fracture	Splint	Disposition
Proximal	Sling and swathe splint, or coaptation splint	Non-emergent Ortho follow up
Shaft	Long arm posterior splint, sling and swathe splint, or coaptation splint	Non-emergent Ortho f/u
Supracondylar	Long Arm Posterior Splint	Ortho consult for Type 2 or 3

External Links

References

Authors:

@@ Line 1: / Line 1: @@
-= Proximal Fracture =
+{{Peds top}} [[Humerus fracture]].''
+==Background==
+[[File:Communitive midshaft humeral fracture callus.jpg|thumb|Comminuted midshaft humeral fracture with callous formation]]
+{{Proximal arm fracture DDX}}
-[[Image:Prox humerus fracture.jpeg|thumb|Alt]]
+==Clinical Features==
+*History of trauma
+*Pain over fracture site
-=== Background  ===
+==Differential Diagnosis==
+{{Shoulder DDX}}
-*Occurs predominantly during adolescence
+==Evaluation==
-*Proximal fractures classified using the Neer classification system based on number of component fracutes
+===Workup===
-=== Treatment ===
+===Diagnosis===
-*Depends on the age of the child and degree of displacement
+==Management & Disposition==
-**Ortho consult is needed to determine the best approach
+{{General Fracture Management}}
-=== Disposition ===
+{{Pediatric Humerus Fracture Management Table}}
-*Slightly displaced fx: Sling and ortho f/u
-*Displaced &gt;30 degrees: may need closed reduction
-==Diaphysis Fracture==
-===Background===
-*Uncommon
-**Consider abuse
-**Direct trauma: transverse fx
-**Violent rotation: spiral fx
-*Fracture fragment may injure radial nerve
-**Assess wrist extensors/supinators
-**Sensation of dorsoradial hand, thumb, and second digits
-===Treatment===
-*Long-arm plaster splint
-===Disposition===
-*Ortho f/u
 ==See Also==
-[[Supracondylar Fracture]]
+*[[Fractures (main)]]
+*[[Splinting]]
-== Source ==
-Tintinalli
+==External Links==
-Harwood Nuss
+==References==
+<references/>
-[[Category:Peds]] [[Category:Ortho]]
+[[Category:Orthopedics]]