Paediatric Humeral Shaft Fractures: An Overview and Modern Management Approach

Abstract

Paediatric humeral shaft fractures are a relatively uncommon injury comprising less than 3% of all paediatric fractures. Although these injuries are uncommon, it is important to be familiar with managing such injuries and recognising which types of fractures require surgical stabilisation or referral to specialist tertiary care. This paper provides a broad overview of humeral diaphyseal fractures in children including key management principles. We discuss aetiology, non-accidental trauma (NAT), clinical findings, imaging, fracture patterns, classification, associated injuries, management (non-operative and operative) and complications. Due to the increasing trend of managing these injuries with surgical fixation, we also review the recent available literature evaluating these surgical options. Overall, there is good evidence that the majority of humeral shaft fractures in children and adolescents can be successfully managed non-operatively. However, operative management when clinically indicated, especially in older children and adolescents, has shown to be beneficial with good clinical outcomes and low complication rates. Further research with paediatric-specific core outcomes is recommended to further evaluate this underrepresented topic.