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Creating Rigidly Stabilized Fractures for Assessing Intramembranous Ossification, Distraction Osteogenesis, or Healing of Critical Sized Defects
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Ipsilateral Displaced Physeal Fractures of the Proximal and Distal Humerus with Subperiosteal Extrusion in a

Aditya Kaushal1, Sanya Vermani2, Jessica Kaushal3

  • 1Department of Orthopaedics, PGIMER, Chandigarh, India.

JBJS Case Connector
|February 1, 2022
PubMed

Insights

Manipulation by bonesetters caused a rare humerus physeal separation in a child. Surgical fixation led to a good outcome, highlighting the risks of non-medical bone manipulation.

Area of Science:

  • Orthopaedic Surgery
  • Pediatric Orthopaedics
  • Traumatology

Background:

  • Manipulation by bonesetters is prevalent in developing nations, often leading to adverse outcomes.
  • This practice can result in severe skeletal injuries, complicating treatment.
  • Regional orthopaedic surgeons must be aware of the challenges posed by bonesetter-induced injuries.

Observation:

  • A 6-year-old male presented with ipsilateral proximal and distal physeal separation of the humerus.
  • The injury occurred after manipulation by a bonesetter, with associated subperiosteal extrusion.
  • The patient underwent open reduction and internal fixation using Kirschner wires.

Findings:

  • The surgical intervention successfully stabilized the humerus fracture.
  • At 1.5-year follow-up, the child exhibited minimal shortening (0.5 cm).
  • The patient reported no pain or instability, indicating a positive functional recovery.

Implications:

  • This case underscores the potential for serious complications from non-medical bone manipulation.
  • Effective surgical management can achieve favorable outcomes even in complex physeal injuries.
  • Awareness and preparedness are crucial for orthopaedic surgeons managing such cases.
Abstract

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