Abstract：
OBJECTIVE: To report the functional results of our experience and to describe intraoperative findings and complications due to the techniques used in our service.
METHODS: From January 2018 to December 2022, 27 Pediatric patients aged from 8 to 16 years underwent surgery to treat proximal humerus fractures. Their demographic characteristics were evaluated, as well as their clinical characteristics on admission, type of reduction (closed/open), presence of interposition in open reductions, type of implant, complications, and functional range of movement according to two shoulder functional scores.
RESULTS: Mean age was 11.2 years (8-15), there was a predominance of males, who accounted for 70% of the cases, and sports accidents were the cause of injury in 44% of the cases. Anatomical location was balanced between patients, including 55% of physeal fractures and 45% of metaphyseal ones. Overall, 81.5% of patients required open reduction to achieve axis correction, and that 55.5% of fractures were fixed with Kirschner wires, and 44, 4% with elastic titanium nails. Mean QuickDASH score was 0.58 (0-1.7), and Constant score was 9 (3-24). There were no major complications, but 27% of cases subjected to open reduction presented a hypertrophic scar.
CONCLUSIONS: Surgical treatment of severely displaced proximal humerus fractures is successful, both with closed and open reduction; type of implant does not play a key role and should be selected based on the characteristics of each case. Surgical training should prevail at the time of decision-making. When these recommendations are followed, results can be excellent and sequelae are infrequent.
METHODS: From January 2018 to December 2022, 27 Pediatric patients aged from 8 to 16 years underwent surgery to treat proximal humerus fractures. Their demographic characteristics were evaluated, as well as their clinical characteristics on admission, type of reduction (closed/open), presence of interposition in open reductions, type of implant, complications, and functional range of movement according to two shoulder functional scores.
RESULTS: Mean age was 11.2 years (8-15), there was a predominance of males, who accounted for 70% of the cases, and sports accidents were the cause of injury in 44% of the cases. Anatomical location was balanced between patients, including 55% of physeal fractures and 45% of metaphyseal ones. Overall, 81.5% of patients required open reduction to achieve axis correction, and that 55.5% of fractures were fixed with Kirschner wires, and 44, 4% with elastic titanium nails. Mean QuickDASH score was 0.58 (0-1.7), and Constant score was 9 (3-24). There were no major complications, but 27% of cases subjected to open reduction presented a hypertrophic scar.
CONCLUSIONS: Surgical treatment of severely displaced proximal humerus fractures is successful, both with closed and open reduction; type of implant does not play a key role and should be selected based on the characteristics of each case. Surgical training should prevail at the time of decision-making. When these recommendations are followed, results can be excellent and sequelae are infrequent.
摘要：
目的：报告我们的经验的功能结果，并描述术中发现和由于我们服务中使用的技术而引起的并发症。
方法：从2018年1月至2022年12月，27名年龄在8至16岁之间的儿科患者接受了手术治疗肱骨近端骨折。评估了他们的人口统计学特征，以及他们入院时的临床特征，还原类型（关闭/打开），在开放还原中存在干预，植入物的类型，并发症,和根据两个肩部功能评分的运动功能范围。
结果：平均年龄为11.2岁（8-15岁），男性占主导地位，占70%的病例，在44%的案例中，运动事故是造成伤害的原因。患者之间的解剖位置平衡，包括55%的phy骨骨折和45%的干phy端骨折。总的来说,81.5%的患者需要切开复位以实现轴矫正，55.5%的骨折是用克氏针固定的，和44，4%的弹性钛钉。平均QuickDASH评分为0.58（0-1.7），和常数评分为9（3-24）。没有重大并发症,但27％的病例进行了开放复位表现出肥厚性瘢痕。
结论：严重移位肱骨近端骨折的手术治疗是成功的，闭合和切开复位；植入物的类型起不到关键作用，应根据每种情况的特点进行选择。手术培训应在决策时为准。当遵循这些建议时，结果可能很好，后遗症很少。
方法：从2018年1月至2022年12月，27名年龄在8至16岁之间的儿科患者接受了手术治疗肱骨近端骨折。评估了他们的人口统计学特征，以及他们入院时的临床特征，还原类型（关闭/打开），在开放还原中存在干预，植入物的类型，并发症,和根据两个肩部功能评分的运动功能范围。
结果：平均年龄为11.2岁（8-15岁），男性占主导地位，占70%的病例，在44%的案例中，运动事故是造成伤害的原因。患者之间的解剖位置平衡，包括55%的phy骨骨折和45%的干phy端骨折。总的来说,81.5%的患者需要切开复位以实现轴矫正，55.5%的骨折是用克氏针固定的，和44，4%的弹性钛钉。平均QuickDASH评分为0.58（0-1.7），和常数评分为9（3-24）。没有重大并发症,但27％的病例进行了开放复位表现出肥厚性瘢痕。
结论：严重移位肱骨近端骨折的手术治疗是成功的，闭合和切开复位；植入物的类型起不到关键作用，应根据每种情况的特点进行选择。手术培训应在决策时为准。当遵循这些建议时，结果可能很好，后遗症很少。
