Proximale Humerusfrakturen im Kindesalter

Abstract Proximal humerus fractures are rare in pediatrics. The shoulder x-ray is the diagnostic gold standard, allowing classification according to AO or Neer and Horowitz. Non-operative and operative treatments can be followed but a clear guideline for treatment selection is missing. We observed that most of the fractures can be treated non-operative due to the high growth potential of the proximal humerus. Fractures which are open, feature a neurovascular system damage, show a higher grade in dislocation, or present in polytraumatic or older children with limited growth potential should be treated operative. In these cases, a closed reposition and K-wire fixation or intramedullary nailing might be sufficient and provide a less invasive option. However, if this is unsatisfying, an open reduction and internal fixation with locking plates are needed.