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The Journal of Bone and Joint Surgery 79:760-62 (1997)
© 1997 The Journal of Bone and Joint Surgery, Inc.

Avascular Necrosis of the Proximal Humeral Epiphysis after Physeal Fracture. A Case Report*

ROBERT P. MARTIN, M.D.{dagger} and DAVID L. PARSONS, M.D., F.R.C.S.(C){ddagger}, ST. JOHN'S, NEWFOUNDLAND, CANADA

Investigation performed at Charles A. Janeway Child Health Center, St. John's


   Introduction
 
Neer and Horwitz reported that eighty-nine (4 per cent) of 2500 consecutive physeal fractures involved the proximal humeral physis, and Peterson and Peterson reported that twenty-two (7 per cent) of 330 physeal fractures involved the proximal portion of the humerus. Complications associated with fractures of the proximal humeral physis are uncommon1,3-5,7,9-14,16,17. Avascular necrosis of the humeral head is a well known complication following proximal humeral fractures in adults, particularly three-part and four-part fractures2. We report the first documented case, to our knowledge, in the English-language literature, of avascular necrosis of the humeral head following a fracture of the proximal humeral physis.


   Case Report
 
A fourteen-year-old boy was seen in the emergency department because of pain in the right shoulder that had begun immediately after he was body-checked during a hockey game. There was no evidence of dislocation of the shoulder. The results of a neurovascular examination of the right upper . . . [Full Text of this Article]


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 Arch Fam MedHome page
C. J. Wolfe and K. L. Taylor-Butler
Avascular Necrosis: A Case History and Literature Review
Arch Fam Med, March 1, 2000; 9(3): 291 - 294.
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