Fractures of the proximal humerus in children. Nine-year follow-up of 64 unoperated on cases.

Fracture of the proximal humerus in children is rare. The records from 1976 to 1977 of 77 patients aged 0-15 years with a fracture or epiphyseal separation of the proximal humerus were reviewed. Totally, 64 of 72 patients had a follow-up examination (median observation time 9 years). Twenty-one children had an epiphyseal separation and 51 a metaphyseal fracture. All but 1 were treated conservatively. Seven had slight sequelae at follow-up, i.e., transient pain or minor restriction of motion. The rest were asymptomatic. Full remodeling of fractures left displaced occurred in all the cases. No avascular necrosis or shortening of the humerus were found. Nonoperative treatment is appropriate for proximal humeral fractures in children, even for those with extensive displacement.