CASE: An 11-month-old boy was brought to the emergency department because he was refusing to use his right arm. X-rays demonstrated an anteroinferior Salter-Harris I fracture-dislocation of the proximal humeral epiphysis. Closed reduction with sedation was unsuccessful, so open reduction under general anesthesia was pursued. At 2 years, the patient has made a full recovery. CONCLUSION: Pediatric shoulder fracture-dislocations are rare. Clinicians must have a high index of suspicion for nonaccidental trauma when evaluating such injuries. When this injury is encountered in patients younger than 1 year, open reduction of the proximal humeral epiphysis can be a successful treatment option.
CASE: An 11-month-old boy was brought to the emergency department because he was refusing to use his right arm. X-rays demonstrated an anteroinferior Salter-Harris I fracture-dislocation of the proximal humeral epiphysis. Closed reduction with sedation was unsuccessful, so open reduction under general anesthesia was pursued. At 2 years, the patient has made a full recovery. CONCLUSION: Pediatric shoulder fracture-dislocations are rare. Clinicians must have a high index of suspicion for nonaccidental trauma when evaluating such injuries. When this injury is encountered in patients younger than 1 year, open reduction of the proximal humeral epiphysis can be a successful treatment option.