WOFAPS 2025 8th World Congress of Pediatric Surgery

Shan Feng, Yunfang Zhen

Children's Hospital Affiliated to Soochow University

Purpose

The main objective of this study was to retrospectively evaluate the clinical and radiographic outcomes of displaced proximal humeral fractures in children treated by nonoperatively treatment with early traction and subsequent immobilization.

Methods

A retrospective review of 83 patients aged 3–15 years old with displaced proximal humeral fractures at our institution between 2018 and 2021 was performed. These patients were followed up and assessed using the Neer Shoulder score and the Quick-DASH (Disability of the Arm, Shoulder and Hand). Radiographs were assessed for deformity. Subjective satisfaction was assessed.

Results

Only 2 patients over 14 years old changed to the surgical treatment because of the severe displacement more than 100% in the X-ray after one week from the injury. The other 81 patients were followed up for an average of 7.9 months (3-15 months).All fractures were radiologically united at a median time of 5.0 weeks (4–10 weeks). At the follow-up, Neer Shoulder score at the last follow-up was mean score 95.07±3.69 (range 86–100). Quick-DASH score was 3.11±8.20 (range 0–9.1). In a subjective measure of outcome at follow- up, 63(77.7%) of patients were very satisfied and 18(22.3 %) satisfied; no patients reported their outcome as not satisfied.

Conclusions

We commend nonoperatively treatment with early traction and subsequent immobilization in the management of the displaced proximal humeral fractures in children of all ages. The determination of changing treatment plan to surgical management in the patients is rare.