Evaluation and Management of Pediatric Humeral Shaft Fractures

• Published in: Journal of the American Academy of Orthopaedic Surgeons Vol. 31; no. 6; p. 265
• Main Authors: Annabell, Lucas, Shore, Benjamin J, Hedequist, Daniel J, Hogue, Grant D
• Format: Journal Article
• Language: English
• Published: United States 15.03.2023
• Subjects: Bone Plates; Child; Fracture Fixation, Internal - methods; Humans; Humeral Fractures - surgery; Humerus; Radial Neuropathy; Treatment Outcome
• DOI: 10.5435/JAAOS-D-22-00443

Diaphyseal humerus fractures in the pediatric population have dynamic treatment strategies that depend on injury pattern, mechanism, patient skeletal maturity, and size. Treatment strategies include closed reduction with various immobilization techniques, flexible nails, uniplanar or multiplanar external fixation, or plate osteosynthesis. Accepted parameters for sagittal and coronal alignment vary based on age and potential for remodeling, and the multiplanar motion of the shoulder joint can accommodate for greater variations in alignment than many other long bone fractures. Complications such as radial nerve palsy are possible with both open and closed injuries, and mal/nonunions, although rare, can occur. Overall, treatment should be predicated on a full evaluation of the patient, fracture, local soft tissues, and any concomitant injuries.