Presentation
Fall down on left shoulder since one month, treated in another hospital by arm sling only. Presented with left shoulder inability and limited passive motion.
Patient Data
Proximal humerus physeal fracture with complete physeal separation and slipped proximal humeral epiphysis medially and inferiorly. It is considered a Salter-Harris type I fracture.
Mild glenohumeral joint effusion.
Proximal humerus physeal fracture with complete physeal separation and slipped proximal humeral epiphysis medially and inferiorly. It is considered a Salter-Harris type I fracture.
Fractured bone chip at the anterolateral aspect of the proximal humeral metaphysis.
Mild glenohumeral joint effusion.
Case Discussion
Plain radiographs show a proximal humerus fracture that occured through the epiphyseal plate causing slipped proximal humeral epiphysis medially and inferiorly, like ice cream from a cone. So, it is considered a Salter-Harris type I fracture. See similar case (rID-170191).
Proximal humeral Salter-Harris type II fracture is most frequent after 12 years than type I fractures. Classically, type II features involve fracture of medial part of proximal humeral metaphysis. See case (rID-95758).
Generally, proximal humeral physeal injuries are treated non-operatively. Patients older than 11 years with significant displacement usually require closed reduction with percutaneous screws or wires.
There is also non-fusion of the coracoid ossification centre, which completely fuses by 16-17 years of age, which mimics a fractured base of coracoid process.
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