Proximal humerus fractures in adolescents: Experience from east of Scotland

Jun Wei Lim (Lead / Corresponding author), Donald M. Campbell, Benedict A. Clift

Research output: Contribution to journalArticlepeer-review

Abstract

Background: The management of proximal humerus fractures (PHF) in adolescent has not been agreed upon. We aim to investigate the outcomes of PHF managed conservatively in adolescents.

Methods: All shoulder radiographs performed in patients aged from 10 to 18 years and from 2008 to 2015 were reviewed. The radiological parameters, including anatomical side, Neer and Horwitz displacement grade, angulation and any residual deformities were recorded. Mail questionnaires based on the modified 15-Upper Extremities Functional Index (15-UEFI), with a maximum of 59 points, were sent out. The return of the completed anonymized questionnaire was considered as implied consent.

Results: 118 patients with a median age of 12 at the time of fracture were identified. The majority of the fractures were Neer and Horwitz grade I displacement and 3 children had Neer and Horwitz grade III and IV displacement. The median angulation was 25°. The median follow-up length was 26 days. 55 patients had residual angulation and 25 patients had worsened angulation. No non-union was identified. No patients underwent subsequent corrective surgeries. 35 patients responded to the questionnaire. The median 15-UEFI was 59 points. None of the patients have contacted the research or clinical team regarding any concerns.

Conclusion: The vast majority of non-displaced and minimally displaced PHF in adolescent were managed conservatively in our unit. The functional outcomes for this cohort remain excellent even for those with residual deformities in the follow-up radiographs. Further large prospective multicenter studies on adolescent cohort with significantly displaced PHF are warranted.

Original languageEnglish
Pages (from-to)31-39
Number of pages9
JournalSurgeon
Volume21
Issue number1
Early online date12 Mar 2022
DOIs
Publication statusPublished - Feb 2023

Keywords

  • Adolescents
  • Conservative management
  • Follow up
  • Proximal humerus fracture
  • Questionnaire study

ASJC Scopus subject areas

  • Surgery

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