Authors of section

Authors

Anna Clarke, Dorien Schneidmüller

Executive Editors

Mamoun Kremli

General Editors

Fergal Monsell

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Simple complete metaphyseal fracture

Definition

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.

Simple/multifragmentary complete metaphyseal fractures, proximal humerus: 11-M/3.1; transverse more stable than oblique.

Further characteristics

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 fractures common in children; 80% growth, usually heal/remodel (less near maturity). Case: metaphyseal fracture, 4-year-old; 1-year x-ray shows remodeling. Minor trauma may indicate undiagnosed cyst.

X-ray

AP and lateral x-rays should be obtained.

Transthoracic views should be avoided.

Obtain AP and lateral x-rays; avoid transthoracic views.

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

Metaphyseal fracture with significant translation in a 14-year-old male.
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