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Pediatric Humeral Tuberosity Fractures: Presentation, Management, and Early Outcomes.

David Isaacs1, Akbar N Syed2, Carlos Yaya-Quezada3

  • 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

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Summary

Pediatric greater and lesser tuberosity fractures have different injury mechanisms and outcomes. Early diagnosis and surgical consideration are key, as nonoperative management and delayed diagnosis increase complication risks, especially for lesser tuberosity fractures.

Keywords:
Case seriesGreater tuberosityLesser tuberosityPediatric proximal humerus

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Area of Science:

  • Orthopedic surgery
  • Pediatric trauma
  • Fracture management

Background:

  • Humeral tuberosity fractures are rare in children.
  • Limited data exists on pediatric greater tuberosity (GT) fractures compared to lesser tuberosity (LT) fractures.

Purpose of the Study:

  • To describe the presentation, management, and early outcomes of pediatric GT and LT fractures.
  • To analyze injury mechanisms and complication rates associated with these fractures.

Main Methods:

  • Retrospective review of pediatric patients with humeral tuberosity fractures (2008-2024).
  • Exclusion of patients with inadequate documentation or neuromuscular conditions.
  • Descriptive statistical analysis of demographic, injury, and treatment data.

Main Results:

  • Nineteen patients (10 GT, 9 LT) were analyzed; all were male, mean age 14.6 years.
  • Sports activities were common for LT (77.8%), while trauma was common for GT (70.0%).
  • Complications (36.8%) were higher with LT fractures, nonoperative management, and delayed diagnosis.

Conclusions:

  • GT and LT fractures have distinct injury mechanisms.
  • Advanced imaging is often necessary due to potential radiographic occultness.
  • Higher complication rates necessitate careful selection for surgical candidates and prompt diagnosis.