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Functional results of displaced proximal humerus fractures in children treated by elastic stable intramedullary nail
1Department of Pediatric Surgery, CHUl Estaing, 1, Place Lucie et Raymond Aubrac, Clermont Ferrand, 63003, France.
Insights
Elastic stable intramedullary nailing (ESIN) effectively treats displaced proximal humerus fractures in children. Patients experienced good functional outcomes and returned to daily activities without pain.
Area of Science:
- Pediatric Orthopedics
- Traumatology
- Surgical Innovation
Background:
- Displaced proximal humerus fractures are common in children.
- Elastic stable intramedullary nailing (ESIN) is a viable treatment option.
- Evaluating functional outcomes is crucial for pediatric fracture management.
Purpose of the Study:
- To assess the functional outcomes of pediatric patients with displaced proximal humerus fractures treated with ESIN.
- To compare outcomes between epiphyseal and metaphyseal fractures.
- To analyze outcomes based on age (younger vs. older than 10 years).
Main Methods:
- A cohort of 27 pediatric patients with closed, displaced proximal humerus fractures underwent ESIN.
- Patients were monitored clinically and radiographically.
- Functional outcomes were evaluated using the French QuickDash scale after hardware removal.
Main Results:
- The mean QuickDash score was 2.0, indicating good functional recovery.
- Most patients (58.3%) achieved a score of 0, signifying excellent outcomes.
- Full range of motion was preserved, and patients returned to daily and sports activities without pain.
Conclusions:
- ESIN provides good functional results for pediatric displaced proximal humerus fractures.
- Standardized evaluation scales like QuickDash are recommended for consistent assessment.
- The technique is effective for both epiphyseal and metaphyseal injuries across different age groups.
Purpose:
Displaced proximal humerus fractures within the pediatric population can be treated by elastic stable intramedullary nailing (ESIN). The main objective of our study is to evaluate functional outcome of the displaced proximal humeral fractures treated by ESIN within the pediatric group using a standardized evaluation scale. The secondary goal is to compare functional outcome of epiphyseal and metaphyseal injuries and functional outcome of children younger and older than 10 years of age.
Materials And Methods:
From March 2010 to December 2011, 27 children had been treated surgically using ESIN for displaced fractures at the proximal extremity of the humerus. These fractures were displaced and closed without neurovascular insult. Patients were followed radiographically and clinically on a regular basis. After hardware removal, the functional outcomes had been homogeneously assessed by using the French edition of the QuickDash(®) evaluation scale. The descriptive statistics including mean, standard deviation, and confidence interval have been realized.
Results:
We included 27 children who were operated on consecutively (10 boys, 17 girls). The mean age at the time of operation is 11.2 ± 2.7 years (range 7.1-15.9). The mean angulation is 55.9° ± 20.3° (range 20-90). The mean apposition is 52.8 % ± 33.1 (range 10-100). The mean follow-up period is 15.2 ± 5.6 months (range 6.1-28.5). Results were considered good for children between 7.1 and 15.9 years old with epiphyseal and meataphyseal fractures. The mean QuickDash(®) score is 2.0 (range 0-6.5), with 14 cases showing a score of 0 (58.3 %), 2 cases with 4.3 (8.3 %), 4 cases with 4.5 (16.7 %), and 4 cases with a score of 6.5 (16.7 %). Ranges of movement were preserved. The patients regained their daily and sportive activity over the time without pain or discomfort.
Conclusion:
Our study showed a good outcome of functional results within a pediatric population who had a sustained displaced proximal humeral fracture and treated by ESIN. Using a standardized evaluation scale is recommended in order to be able to evaluate the patients in a homogeneous manner.
