The following left shoulder x-rays are from a 13 year old who has presented with left shoulder pain and reduced movement after falling on his outstretched left hand a few hours ago. What do you observe?[peekaboo_link name=”Answer”]Answer[/peekaboo_link] [peekaboo_content name=”Answer”]
The shoulder x-rays show a Salter-Harris Type I fracture of the proximal humeral epiphysis. There is widening of the epiphyseal plate along with abnormal medial angulation.
Proximal humeral epiphyseal fractures:
- Common between the ages of 11-15.
- Usually Salter Harris Type I or Type II (which is more common).
- Proximal humeral growth plate closes between 16-19 years and accounts for 80% of the longitudinal growth of humerus with good remodelling potential. Thus, most injuries are managed conservatively.
Beginners often confuse normal proximal humeral growth plate for a fracture.
This patient was managed conservatively by the specialist.