Which proximal humerus fractures should be pinned? Treatment in skeletally immature patients

Erik C.B. King, Stephanie B. Ihnow*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Most proximal humerus fractures in skeletally immature individuals are treated nonoperatively with excellent functional results. Extensive remodeling of the proximal humerus and the wide arc of motion of the glenohumeral joint accommodate a large degree of fracture displacement and angulation. The treatment of severely displaced fractures and/or severely angulated fractures continues to be debated. Older patients and those with significantly displaced fractures may benefit from surgery because of their inability to remodel displacement and angulation during their limited remaining growth. The decision to treat a proximal humerus fracture in a skeletally immature patient operatively versus nonoperatively is dependent on the following 3 factors: displacement, bone age, and capacity to remodel. There is an increasing trend toward treating severely displaced and severely angulated fractures surgically, especially in older patients and adolescents. Smooth wires, percutaneous threaded wires, cannulated screws, and retrograde elastic stable intramedullary nailing are acceptable options for fixation.

Original languageEnglish (US)
Pages (from-to)S44-S48
JournalJournal of Pediatric Orthopaedics
Issue number4
StatePublished - 2016


  • adolescent
  • nonoperative versus operative treatment
  • pediatric
  • proximal humerus fracture

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Orthopedics and Sports Medicine


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