Brachial Artery Injury With a Proximal Humerus Fracture in a 10-Year-Old Girl

Abstract not available. Introduction provided instead.

Proximal humerus fractures in children are uncommon; their incidence is 1.2 to 4.4 per 1000 per year or fewer than 5% of all pediatric fractures.¹ Nearly all these fractures are treated conservatively because of the potential to heal and remodel without significant residual functional deficits.^2,3 Pediatric orthopedic textbooks describe complications associated with proximal humerus fractures, but none of those reviewed describes a concomitant vascular injury.^1,4 To our knowledge, there
have been only 2 published reports of such an injury, and both involved a Salter-Harris type II fracture of the proximal humerus and associated vascular injury.^5,6

In this article, we describe the presentation, evaluation, and treatment of a 10-year-old girl with an extraphyseal proximal humerus metaphyseal fracture and brachial artery injury—an injury constellation that to our knowledge has not been reported before. A vascular injury associated with a proximal humerus fracture secondary to blunt trauma is uncommon even in adults, and we review the
literature on this uncommon injury in both the adult and the pediatric population.