Percutaneous Fixation of Pediatric Proximal Humerus Fractures Master's Surgical Technique

Abstract

Proximal humerus fractures can be seen in children and adolescents after a fall or following significant trauma, like motor vehicle accidents. Significant remodeling potential from the proximal humeral physis along with the wide arc of motion of the shoulder allow for good outcomes with nonoperative care for minimally displaced fractures and fractures in younger children.  Operative management is reserved for fractures with greater displacement and angulation, particularly in adolescents nearing skeletal maturity.  Closed reduction techniques in the operating room can be difficult due to patient size, fracture displacement, interposed tissue, and deforming forces acting on the proximal humerus.  Skeletal stabilization after closed reduction can include percutaneous pins, screws and flexible nails.  Here, we describe a technique for percutaneous reduction and fixation of the difficult-to-reduce proximal humerus fracture.