What are the surgical treatments for proximal humeral fractures in children?

Proximal humeral fracture in children is a common condition in life, usually occurring after a fall. It is a painful thing for children and can cause serious physical and psychological harm to children. After this happens, parents must pay attention to it and go to the hospital for examination and treatment in time. Generally, surgical treatment is the main treatment. So, what are the surgical treatments for proximal humeral fractures in children? Let’s find out below.

General anesthesia or brachial plexus anesthesia, with the patient lying or sitting. Through the pectoralis major deltoid space approach, after protecting the cephalic vein, pull it outward to expose the proximal humerus and check whether the rotator cuff is ruptured or torn. After the fracture is reduced, it is temporarily fixed with Kirschner wires. The fracture ends are confirmed to be well reduced under C-arm X-ray fluoroscopy. The LPHP plate is placed at the proximal end of the humerus, and the drilling speed should be slow. Two to three locking screws are usually used in the humeral head. If the distal end of the fracture is cortical bone, it can be fixed with locking screws or ordinary 3.5mmAO standard cortical bone screws. If the rotator cuff is ruptured or torn, the tendons of the supraspinatus and subscapularis can be fixed to the suture holes of the bone plate with 5# non-absorbable sutures, and the shoulder joint can be moved to check whether the fixation is reliable. Negative pressure drainage was placed to close the wound layer by layer.

The neck and wrist brace was fixed after the operation. Functional exercises of wrist and elbow joints were started 3 days after the operation. Shoulder joint swing exercises were performed 2 weeks after the operation. Shoulder joint elevation exercises were performed 3 weeks after the operation.

Through the above introduction, we know what are the surgical treatment methods for proximal humeral fractures in children. During the postoperative period, we should also pay more attention to the care of children, not only in terms of diet, but also in life and psychology. Appropriate rehabilitation training should also be carried out during the rehabilitation process.