Humerus fracture (peds)
Revision as of 18:55, 22 March 2023 by Rossdonaldson1 (talk | contribs) (→Management & Disposition)
This page is for pediatric patients. For adult patients, see: Humerus fracture.
Background
Humerus Fracture Types
Clinical Features
- History of trauma
- Pain over fracture site
Differential Diagnosis
Shoulder and Upper Arm Diagnoses
Traumatic/Acute:
- Shoulder Dislocation
- Clavicle fracture
- Humerus fracture
- Scapula fracture
- Acromioclavicular joint injury
- Glenohumeral instability
- Rotator cuff tear
- Biceps tendon rupture
- Triceps tendon rupture
- Septic joint
Nontraumatic/Chronic:
- Rotator cuff tear
- Impingement syndrome
- Calcific tendinitis
- Adhesive capsulitis
- Biceps tendinitis
- Subacromial bursitis
- Cervical radiculopathy
Refered pain & non-orthopedic causes:
- Referred pain from
- Neck
- Diaphragm (e.g. gallbladder disease)
- Brachial plexus injury
- Axillary artery thrombosis
- Thoracic outlet syndrome
- Subclavian steal syndrome
- Pancoast tumor
- Myocardial infarction
- Pneumonia
- Pulmonary embolism
Evaluation
Workup
Diagnosis
Management & Disposition
General Fracture Management
- Acute pain management
- Open fractures require immediate IV antibiotics and urgent surgical washout
- Neurovascular compromise from fracture requires emergent reduction and/or orthopedic intervention
- Consider risk for compartment syndrome
Pediatric Humerus Fracture Management Table
| Fracture | Splint | Disposition |
| Proximal | Non-emergent Ortho follow up | |
| Shaft | Non-emergent Ortho f/u | |
| Supracondylar | Long Arm Posterior Splint | Ortho consult for Type 2 or 3 |