Shoulder Fractures in Children and Adolescents

Shoulder fractures (proximal humerus) in children can occur in multiple ways.  Most of these injuries occur around the top part of the arm bone, known as the humerus.  They can occur around or at the growth plate or below it.  Given the large amount of growth that occurs in the humerus bone near the shoulder, a significant amount of remodelling often occurs with time in these children.

Sometimes these do require surgery involving re-positioning of the fracture under anesthetic, and may require metal hardware to maintain position for appropriate healing.

In adolescents especially, these fractures can be challenging to reposition non-surgically since the long head of the biceps tendon can get stuck in the fracture site.  In such cases it is often necessary to make an incision to properly position the fracture and then stabilise it with either pins or a plate and screws.  Pins typically remain in plate for 3 weeks and then are removed in a straightforward manner in the clinic.

 Occasionally growth disturbances can result from injuries that occur through the growth plate but this is uncommon. 

 

 

 Displaced fracture of upper humerus through  growth plate.   

Displaced fracture of upper humerus through  growth plate.

 

 Fracture repositioned and stabilised with temporary pins.

Fracture repositioned and stabilised with temporary pins.