Proximal humerus fracture (peds): Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "fx " to "fracture ") |
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== Background | == 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 | ||
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*US may be used in newborns before ossification centers present | *US may be used in newborns before ossification centers present | ||
== Treatment | == Treatment == | ||
*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''' | ||
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*Intraarticular fracture | *Intraarticular fracture | ||
== Disposition | == Disposition == | ||
*Slightly displaced fracture: Sling and ortho f/u | *Slightly displaced fracture: Sling and ortho f/u | ||
*Displaced >30 degrees: may need closed reduction | *Displaced >30 degrees: may need closed reduction | ||
== See Also == | == See Also== | ||
*[[Humerus fracture]] | *[[Humerus fracture]] | ||
Revision as of 11:13, 6 July 2016
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
Diagnosis
- XR AP Lateral, scapular Y - asses fracture and r/o dislocation
- US may be used in newborns before ossification centers present
Treatment
- 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 f/u
- Displaced >30 degrees: may need closed reduction
See Also
References
- Harwood Nuss
- Orthobullets