Proximal humerus fracture (peds)

Background

• Occurs predominantly during adolescence
• Proximal fractures classified using the Neer classification system based on number of component fractures

Differential Diagnosis

Humerus Fracture Types

Humeral anatomy

• Adult
  • Proximal
  • Shaft
  • Distal
    • Capitellum
    • Trochlea
    • Condylar
• Pediatric
  • Proximal
  • Shaft
  • Distal
    • Supracondylar
    • Lateral epicondyle
    • Medial epicondyle

Diagnosis

• XR AP Lateral, scapular Y - asses fx 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
  • Ortho consult is needed to determine the best approach

Disposition

• Slightly displaced fracture: Sling and ortho f/u
• Displaced >30 degrees: may need closed reduction

See Also

• Humerus fracture

Source

• Tintinalli
• Harwood Nuss