![]() Using an anterior working portal, debridement of the fracture bed from fibrous tissue until reaching bleeding bone within the glenohumeral joint, the fracture configuration, and the fracture margin of the greater tuberosity fracture are determined. Further intra-articular examination revealed normal subscapularis, unstable and friable biceps with complete pulley disruption as seen by palpation, and tear of the supraspinatus from the most anterior part of the greater tuberosity. p.119-34.Ĭontent developed by Victorian Paediatric Orthopaedic Network.Video 1 With patient in beach chair position, an intra-articular arthroscopic examination is done through a posterior portal. Lippincott Williams & Wilkins, Philadelphia 2005. Pediatric Orthopaedic Society of North America. Proximal humerus fractures in the pediatric population: a systematic review. ![]() Pahlavan S, Baldwin K, Pandya N, Namdari S, Hosalkar H. In Tachdjian's Pediatric Orthopedics, 4 th Ed. Lippincott Williams & Wilkins, Philadelphia 2010. In Rockwood and Wilkins' Fractures in Children, 7 th Ed. Fractures of the proximal radius and ulna. Fractures of the proximal humerus and shaft in children. Proximal humeral fractures in children and adolescents. Mild malunion can occur but is not a functional problem.įracture clinics for other potential complications References (ED setting)īahrs C, Zipplies S, Ochs BG, et al. What are the potential complications associated with this injury?Ĭomplications are rare and usually due to associated soft tissue and neurological injuries, i.e. Physeal injuries in adolescents are typically Salter-Harris type I and II with very low subsequent growth arrest rates. ![]() Mild shortening of the humerus and mild angular malunion are not noticeable cosmetically, and function is unaffected. Nonunion is rare and shoulder function usually returns to normal even if there is residual deformity on xray. What advice should I give to parents?ĭue to the remodelling potential of this region, the outcome from this fracture is usually excellent. Patients should be seen in the fracture clinic or by an interested GP within seven days for follow-up with radiographs to assess further displacement. Analgesia and thorough neurovascular assessment are essential. The usual treatment for this fracture is immobilisation of the shoulder in a sling, body swathe or shoulder immobiliser. What is the usual ED management for this fracture?
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