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REVIEW  PEDIATRIC UPPER LIMB FRACTURE 

Minerva Orthopedics 2021 February;72(1):15-23

DOI: 10.23736/S2784-8469.20.04040-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Humeral shaft fractures in children and adolescents

Flavia ALBERGHINA 1, Federico CANAVESE 2, Antonio ANDREACCHIO 3

1 Department of Pediatric Orthopedic Surgery, Regina Margherita Children’s Hospital, Turin, Italy; 2 Department of Pediatric Orthopedic Surgery, Jeanne de Flandre Hospital, Lille University Center, Lille, France; 3 Department of Pediatric Orthopedic Surgery, Buzzi Children’s Hospital, Milan, Italy



INTRODUCTION: Humeral shaft fractures are relatively rare in the pediatric population. Complication such as secondary displacement and refracture are frequent. The forgiving nature of these fractures in young children is the rationale of the conservative treatment. Differently, in older children and adolescents’ controversies exist regarding the role of surgical treatment and method of fixation. The goal of this study is to review the literature on management, complications, and prognosis of humeral shaft fractures in children and adolescents.
EVIDENCE ACQUISITION: A systematic review was carried out following the PRISMA guidelines. The literature search was completed using the PubMed, Google Scholar, Scopus and Cochrane Library databases from the earliest date possible up to September 2020. The inclusion criteria for this study were all of the following: 1) study regarding humeral shaft fractures; 2) focus on children and adolescents aged until 18 years old; 3) the study’s level of evidence was stated as 1 to 4. Data on 200 patients were collected.
EVIDENCE SYNTHESIS: Most of the studies in the available literature on this topic are retrospective, include a little number of patients and no consensus has been found regarding the best surgical treatment.
CONCLUSIONS: Pediatric humeral shaft fractures pose treatment challenges especially in older children and adolescents. Although recent data report high success of elastic intramedullary nailing, future research with randomized trials on a larger number of patients should be focused on determining which treatment algorithms may effectively decrease complication rates and improve clinical and functional outcome.


KEY WORDS: Humerus; Fracture fixation, intramedullary; Fractures, bone; Child

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