Shoulder dislocation combined with proximal humerus fracture in children

Abstract

Rationale:Proximal humerus fracture occuring simultaneously with dislocation of a shoulder in children is extremely rare, with only a few recent reports of on such cases having been reported.Patient concerns:A 6-year-old girl fell from a ladder and landed on her dominant right arm with pain in the right shoulder and unable to perform movements; her shoulder did not allow for passive movements as well.Diagnoses:Proximal humerus fracture combined with shoulder dislocation.Interventions:The patient was treated with open reduction, elastic stable intramedullary nail (ESIN) fixation, immobilization with U-shape cast and shoulder spica brace.Outcomes:The patient was pain-free, with full range movement of the injured shoulder and no sign of avascular necrosis in a 2-year follow-up period.Lessons:We recommend open reduction with ESIN fixation for severely displaced proximal humeral metaphyseal fractures with shoulder dislocation in children. Preoperative bilateral anteroposterior shoulders x-ray is needed to confirm the shoulder location.

Traumatic shoulder fracture-dislocation in a child: An innovative method of closed reduction

“…Jin et al. 3 attempted closed reduction with an elastic stable intramedullary nail (ESIN) but failed and had to perform the open reduction. Isik et al.…”

“…In four cases of fracture-dislocation shoulder where the physeal plate was not involved, 3,[6][7][8] only one was treated by closed reduction of the dislocation with intramedullary fixation of the fracture.…”

“…Closed reduction of fracture and dislocation is always difficult. Jin et al 3 attempted closed reduction with an elastic stable intramedullary nail (ESIN) but failed and had to perform the open reduction. Isik et al 2 reported dislocation with a fracture in a similar age group and claimed excellent results only after open reduction, but the patient took a longer time to achieve full function.…”

“…In most cases, open reduction is chosen in order to fix the fracture and to get a stable reduction of the joint. 2,3 We present the case of a six-year-old girl with a shoulder dislocation and proximal humerus metaphysis fracture, treated by closed reduction using a joystick method and fixation by two intramedullary K-wires achieving a good anatomical reduction of the fracture and shoulder joint with excellent clinical results. There are no previous reports of treatment of fracture-dislocations of the shoulder in children by a closed method using the joystick technique.…”

Glenohumeral joint dislocation is rare in children with proximal humeral fractures: a descriptive study and literature review

“…However, glenohumeral joint dislocation combined with fracture of the humerus is extremely rare in children. Open/closed reduction followed by surgical stabilization using Kirschner wire (KW) or elastic stable intramedullary nail (ESIN) has been reported in a handful of case reports [4]. Nelson G. et al published a study of 220 pediatric proximal humerus fractures without any incidence of glenohumeral joint dislocation [5].…”