Diagnostic arthrogram of a Salter I fracture of the proximal humerus in a newborn

Proximal humeral fractures occurring during breech delivery are rare and are generally Salter-Harris Type I physeal fractures. The absence of a radiographically demonstrable metaphysis attached to the proximal fragment of these fractures often makes them exceedingly difficult to diagnose at first. A recent case demonstrates the usefulness of arthrography and videofluoroscopy as an adjunct to plain radiography in diagnosing such injuries.