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Journal of Bone and Joint Surgery, 1969;51:289-297.
© 1969 by The Journal of Bone and Joint Surgery, Inc

Fractures Involving the Proximal Humeral Epiphyseal Plate

THOMAS B. DAMERON JR. M.D.1 and DONALD B. REIBEL M.D.1

1 The Raleigh Orthopaedic Clinic, 600 Wade Avenue, Raleigh, North Carolina 27605

Fractures that involve the proximal humeral epiphyseal plate usually occur by force being exerted up through the humeral shaft with the arm extended and adducted. The treatment of these fractures consists in pulling the metaphysis back through the defect in the anterior periosteum by exerting traction with the arm abducted and flexed. The metaphysis is then pushed posteriorly into apposition with the epiphysis. If the fracture is stable, it can be immobilized in a modified Velpeau dressing; if it is not stable, the arm should be immobilized in the salute position in a spica cast. Position of the fragment should be checked roentgenographically since the position may change evens in a shoulder spica cast. Because of the anatomical characteristics of the shoulder joint and the humeral epiphyseal plate, more than the usual displacement and angulation can be accepted in the treatment of this epiphyseal injury with the expectation of an excellent result. On the basis of our experience, we believe that open reduction is not indicated for this injury.


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