Simple complete metaphyseal fracture

Simple and multifragmentary complete metaphyseal fractures of the proximal humerus are classified as 11-M/3.1.

A transverse fracture is often more stable than an oblique pattern.

Proximal humeral fractures are common in children. The proximal humeral physis contributes 80% of humeral growth and fractures in this area almost always heal and remodel. The remodeling potential decreases the closer the patient is to skeletal maturity.

This case shows a metaphyseal fracture with complete translation in a 4-year-old patient. The 1-year post-injury x-ray shows remodeling after nonoperative treatment.

Some proximal humeral fractures occur after minor trauma due to an undiagnosed bone cyst in the humeral shaft.

Read about the developmental anatomy in:

• Proximal humeral anatomy

AP and lateral x-rays should be obtained.

Transthoracic views should be avoided.

This case shows a metaphyseal fracture with significant translation in a 14-year-old male patient.