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Fractures of the upper arm,
the humerus, are common. They
typically occur after a fall on the arm or shoulder. These are among the most forgiving fractures
in the body. It is often said that if the ends of the broken humerus are
in the same room, it will heal. Because
the upper growth plate of the humerus accounts for 70% of the overall
growth of the upper arm, this bone has a remarkable capacity for healing
and remodeling. The diagnosis
can be subtle at times. In very
young children and infants, they will simply refuse to use the arm. In older kids, pain and/or deformity are common.
The diagnosis is confirmed by taking an x-ray.
Treatment
of this fracture in children is simple.
Usually, all that is requires is a sling and a swath for comfort. This bone has a remarkable ability to heal
and remodel over a very short period of time.
Parents will often find it disturbing to see the alignment of the
look so bad on the initial x-ray and wonder why the surgeon is not recommending
an operation. There are several
reasons for this. First, healing
is virtually certain. Second,
the bone will remodel completely in almost every case to the point that
you can’t tell that there ever was a fracture after a few years.
Third, because the shoulder is such a mobile joint, minor misalignment
is hard to see and does not make a difference in how the arm works. Several studies
have shown that the worst outcomes for this fracture were when surgery
was done to improve the alignment! Only
if the bone is sticking through the skin or entrapped in the muscle would
we recommend surgery for this fracture. |
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