Abstract
Purpose
To report the functional results of our experience and to describe intraoperative findings and complications due to the techniques used in our service.
Methods
From January 2018 to December 2022, 27 Pediatric patients aged from 8 to 16 years underwent surgery to treat proximal humerus fractures. Their demographic characteristics were evaluated, as well as their clinical characteristics on admission, type of reduction (closed/open), presence of interposition in open reductions, type of implant, complications, and functional range of movement according to two shoulder functional scores.
Results
Mean age was 11.2 years (8–15), there was a predominance of males, who accounted for 70% of the cases, and sports accidents were the cause of injury in 44% of the cases. Anatomical location was balanced between patients, including 55% of physeal fractures and 45% of metaphyseal ones. Overall, 81.5% of patients required open reduction to achieve axis correction, and that 55.5% of fractures were fixed with Kirschner wires, and 44, 4% with elastic titanium nails. Mean QuickDASH score was 0.58 (0–1.7), and Constant score was 9 (3–24). There were no major complications, but 27% of cases subjected to open reduction presented a hypertrophic scar.
Conclusion
Surgical treatment of severely displaced proximal humerus fractures is successful, both with closed and open reduction; type of implant does not play a key role and should be selected based on the characteristics of each case. Surgical training should prevail at the time of decision-making. When these recommendations are followed, results can be excellent and sequelae are infrequent.
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Acknowledgements
We would like to thank the Research Support Group (GAI) of AO Trauma Latin America, for its constant support.
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All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Alberto Daniel Navarro Vergara. The first draft of the manuscript was written by Alberto Daniel Navarro Vergara and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
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The present study was approved by the Research Ethics Committee and by the General Directorate of Hospital de Trauma "Manuel Giagni" under number 23/10-32.HT and complied with institutional and/or national guidelines and principles, as well as with those set forth in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards. The research was classified as harmless to humans. Patients’ personal data were not disclosed, and their medical records were not shared with individuals not belonging to the study group.
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Vergara, A.D.N., Fretes, A.N. Displaced proximal humeral fractures in skeletally immature patients: functional outcomes of surgical treatment. Eur J Orthop Surg Traumatol (2024). https://doi.org/10.1007/s00590-024-03975-x
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DOI: https://doi.org/10.1007/s00590-024-03975-x