Shoulder dislocation combined with proximal humerus fracture in children

Abstract

Rationale: Proximal humerus fracture occuring simultaneously with dislocation of a shoulder in children is extremely rare, with only a few recent reports of on such cases having been reported. Patient concerns: A 6-year-old girl fell from a ladder and landed on her dominant right arm with pain in the right shoulder and unable to perform movements; her shoulder did not allow for passive movements as well. Diagnoses: Proximal humerus fracture combined with shoulder dislocation. Interventions: The patient was treated with open reduction, elastic stable intramedullary nail (ESIN) fixation, immobilization with U-shape cast and shoulder spica brace. Outcomes: The patient was pain-free, with full range movement of the injured shoulder and no sign of avascular necrosis in a 2-year follow-up period. Lessons: We recommend open reduction with ESIN fixation for severely displaced proximal humeral metaphyseal fractures with shoulder dislocation in children. Preoperative bilateral anteroposterior shoulders x-ray is needed to confirm the shoulder location.