Salter-Harris type II proximal humerus injuries: state-of-the-art treatment

Musculoskelet Surg. 2012 Dec;96(3):155-9. doi: 10.1007/s12306-012-0214-3. Epub 2012 Aug 10.

Abstract

Proximal epiphyseal injuries of the humerus represent a very low percentage of traumatic growth pathologies, 5 % of all fractures during childhood. In the literature, there have been only a limited number of clinical studies investigating these injuries, basically from an epidemiological point of view, focusing on the incidence of the different types of fractures. We report our experience of 6 young patients with Salter-Harris type II proximal humerus epiphyseal injuries adopting a minimally invasive surgical technique consisting of closed reduction and percutaneous fixation with Kirschner wires. At 2 years of follow-up, the results consisting in constant; disabilities of the arm, shoulder, and hand; simple shoulder test; and Visual Analogue Scale scores obtained have been excellent and all the patients come back to a normal life with sports practice and normal daily activities. The range of motion was completely restored without any deficit in abduction-adduction, flection-extension, or intra-extra rotation. No differences in anthropometric parameters were found with no case of malangulation, vascular, or neurological complications. Our data support with evidence how the close reduction internal fixation with K-wires treatment can give to the surgeons and the patients a better security about the correct fracture healing. Furthermore, with this article, we will provide a detailed review of the literature in order to define the state-of-the-art treatment to better face such a challenging skeletal injury.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Anthropometry
  • Athletic Injuries / surgery
  • Bicycling / injuries
  • Bone Wires
  • Child
  • Combined Modality Therapy
  • Emergencies
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation
  • Fracture Fixation, Internal / methods*
  • Humans
  • Immobilization
  • Incidence
  • Male
  • Postoperative Complications / epidemiology
  • Radiography
  • Range of Motion, Articular
  • Recovery of Function
  • Shoulder Fractures / diagnostic imaging
  • Shoulder Fractures / surgery*
  • Shoulder Fractures / therapy
  • Treatment Outcome