Fractures around the shoulder in the skeletally immature:A scoping review  

作　　者：Tim Kraal Peter AA Struijs Lisette C Langenberg Christiaan JA van Bergen 

机构地区：[1]Department of Orthopedic Surgery and Sports Medicine,Amsterdam University Medical Centers,Amsterdam 1105 AZ,Netherlands [2]Department of Orthopedic Surgery,NoordWest Ziekenhuisgroep,Alkmaar 1815 JD,Netherlands [3]Department of Orthopedic Surgery and Sports Medicine,Erasmus University Medical Center-Sophia Children’s Hospital,Rotterdam 3015 GD,Netherlands [4]Department of Orthopedic Surgery,Amphia,Breda 4818 CK,Netherlands

出　　处：《World Journal of Orthopedics》2023年第8期604-611,共8页世界骨科杂志（英文版）

摘　　要：Fractures around the shoulder girdle in children are mainly caused by sports accidents.The clavicle and the proximal humerus are most commonly involved.Both the clavicle and the proximal humerus have a remarkable potential for remodeling,which is why most of these fractures in children can be treated conservatively.However,the key is to understand when a child benefits from surgical management.Clear indications for surgery of these fractures are lacking.This review focuses on the available evidence on the management of clavicle and proximal humerus fractures in children.The only strict indications for surgery for diaphyseal clavicle fractures in children are open fractures,tenting of the skin with necrosis,associated neurovascular injury,or a floating shoulder.There is no evidence to argue for surgery of displaced clavicle fractures to prevent malunion since most malunions are asymptomatic.In the rare case of a symptomatic malunion of the clavicle in children,corrective osteosynthesis is a viable treatment option.For proximal humerus fractures in children,treatment is dictated by the patient's age(and thus remodeling potential)and the amount of fracture displacement.Under ten years of age,even severely displaced fractures can be treated conservatively.From the age of 13 and onwards,surgery has better outcomes for severely displaced(Neer types III and IV)fractures.Between 10 and 13 years of age,the indications for surgical treatment are less clear,with varying cut-off values of angulation(30-60 degrees)or displacement(1/3–2/3 shaft width)in the current literature.

关 键 词：Clavicle fracture Proximal humerus fracture PEDIATRIC Skeletally immature CHILDREN SHOULDER 

分 类 号：R726.8[医药卫生—儿科]