Proximal Humeral Fractures

• RARE: <5% of all paediatric fractures.

• Occasionally though benign bone cyst- consider pathological.

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CLASSIFICATION

• Physeal: 

• Metaphyseal: Buckle or complete

• Greater or Lesser tuberosity fracture

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MANAGEMENT

• Analgesia

• Most do not require reduction​

• Broad Arm Sling

• REFER ORTHO IF:
  Significant Angulation/Displacement​

  • AGE 5-12 accept 60 degree angulation and 50% displacement

  • AGE >12 years accept 30 degree angulation and 30% displacement.

• Pathological

• Neuro-vascular compromise​

• Further fracture in the same limb.

• Polytrauma​