An Overview of Management of Surgical Neck Humerus Fractures in Skeletally immature patients

Abstract

Background: Proximal humerus fractures are uncommon in the pediatric age group. Representing about
3% of all fractures and 4% to 7% of all physeal fractures, this type of fracture is more common in males
than in females in a 1:3 ratio, with peaks at ages 10 to 14 years. Fractures of the proximal part of the
humerus, including fractures of the head of the humerus, the epiphysis, and the surgical neck have huge
remodeling potential in young children, as a result of 80% of the longitudinal growth of the arm occurring
at the physis of proximal humerus. Depending on the age of the patient, an excellent result for non-surgical
treatment is expected for children under 11 years of age, as they have a higher remodeling capacity
compared to older children. Several surgical approaches have been described for the treatment of displaced
proximal humeral fractures, open or closed reduction using Kirschner wires, screws and flexible nails, the
most commonly used method is percutaneous K-wires fixation to achieve a satisfactory result in displaced
proximal humeral fractures.