top of page

Topic:

​

Issue:

​

Category:

​

Title:

Is There a Role for Isolated Closed Reduction in the Emergency Department Without Fixation for Displaced Proximal Humerus Fractures in Adolescents?

Author:

Torres-Izquierdo, Beltran MD; Tippabhatla, Abhishek BS; Baldwin, Keith MD, MPH; Upasani, Vidyadhar MD; Sanders, Julia MD; Goldstein, Rachel MD, MPH; Denning, Jaime Rice MD, MS; Hosseinzadeh, Pooya MD

Journal:

Journal of Pediatric Orthopaedics

Date:

April 2024

Reference:

44(4): p e310-e315, DOI: 10.1097/BPO.0000000000002609

Level Of Evidence:

​

# of Patients:

42

Study Type:

Prospective multicenter cohort study

Location:

United States

Summary:

This study evaluates the necessity of closed reduction (CR) compared to immobilization without reduction (INR) for displaced proximal humerus fractures (PHFx) in adolescents treated nonoperatively.

Methods:

Adolescents with displaced PHFx were enrolled across 6 institutions (2018–2022). Patients underwent CR under conscious sedation or INR, followed by immobilization in a hanging arm cast or sling. Outcomes were assessed via radiographs, range of motion, and patient-reported outcomes at 6 weeks and 3 months post-treatment.

Exclusions:

Patients treated operatively or with incomplete follow-up data.

Results:

No significant differences in radiographic alignment, range of motion, or patient-reported outcomes between CR and INR groups. Significant improvements in all outcomes were observed from 6 weeks to 3 months for both groups.

Conclusions:

Nonoperative treatment of displaced PHFx with INR yields outcomes comparable to CR. The findings question the necessity of CR in adolescents with displaced PHFx treated nonoperatively.

Relevance:

Limitations:

Perspective:

bottom of page