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Reverse Total Shoulder Arthroplasty
Published on: July 5, 2011
Proximal humerus Salter type III physeal injury with posterior dislocation
Soon Hyuck Lee1, Dae Hee Lee, Jong Ryoon Baek
1Department of Orthopaedic Surgery, Korea University Hospital, Seoul, Korea.
Archives of Orthopaedic and Trauma Surgery
|December 14, 2006
Summary
This case report details a rare Salter type 3 proximal humerus fracture with posterior dislocation in a teen. MRI was crucial for diagnosis, and while surgery led to good motion, avascular necrosis developed.
Area of Science:
- Orthopedic Surgery
- Pediatric Traumatology
- Radiology
Background:
- Salter type 3 physeal fractures of the proximal humerus are uncommon pediatric injuries.
- Posterior dislocation of the proximal humerus is a rare complication.
Observation:
- A 16-year-old boy presented with a Salter type 3 physeal fracture and posterior proximal humerus dislocation.
- Standard radiography was insufficient; MRI revealed the humeral head locked behind the glenoid labrum.
Findings:
- Open reduction was required for treatment.
- Postoperatively, Magnetic Resonance Imaging (MRI) and radiography detected avascular necrosis of the humeral head 16 months after surgery.
- Despite full range of motion and absence of pain, long-term monitoring is recommended.
Implications:
- This case highlights the diagnostic utility of MRI in complex physeal fractures with dislocation.
- It underscores the potential for avascular necrosis development even with successful initial reduction and functional recovery.
- Emphasizes the need for vigilant, long-term follow-up in similar pediatric shoulder injuries.
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