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What are Pediatric Fractures of the Shoulder?

Pediatric fractures of the shoulder are defined as a break in the shoulder bone of children.

The shoulder is a ball-and-socket joint made up of three bones, namely the humerus (upper arm bone), scapula (shoulder blade), and clavicle (collarbone). The head of the humerus articulates with the socket of the scapula called the glenoid cavity. The clavicle is an S-shaped bone that connects the scapula to the sternum or breastbone. It forms two joints: the acromioclavicular joint, where it articulates with the acromion process of the scapula, and the sternoclavicular joint, where it articulates with the sternum. Tendons and ligaments around the shoulder joint provide strength and stability to the joint.

Causes of Pediatric Fractures of the Shoulder

In general, shoulder fractures in children commonly occur because of falls, sports injuries, and motor vehicle accidents. The clavicle and end of the humerus closest to the shoulder are the bones that usually are broken. The scapula, on the other hand, is not easily fractured because of its protective cover by the surrounding muscles and chest tissue.

Signs and Symptoms of Pediatric Fractures of the Shoulder

The common signs and symptoms of pediatric shoulder fractures include:

  • Pain
  • Swelling
  • Bruising
  • Difficulty in moving the shoulder or arm
  • Numbness, tingling, or coldness in your child’s arm, hand, or fingers
  • A popping sound, also referred to as crepitus, is heard or felt at the time of the fracture

Diagnosis of Pediatric Fractures of the Shoulder

A pediatric shoulder fracture is usually diagnosed based on a thorough physical examination and imaging studies such as X-rays and CT scans of the shoulder bones.

Treatment for Pediatric Fractures of the Shoulder

Treatment for pediatric fractures of the shoulder will depend upon the child's age, the location of the fracture, and the severity of the fracture. Treatment can include non-surgical and surgical methods. These include:

  • Immobilization by placing your arm in a sling, cast, or brace that holds the bones in alignment and limits movement until they heal.
  • Medications such as prescription pain medicines, acetaminophen, and NSAIDs like ibuprofen are used to help reduce swelling, pain, and fever.
  • Application of ice packs to the injured area to help ease or control swelling.
  • Closed reduction: This is a procedure to reduce (set) a broken shoulder bone without cutting the skin open. This method is usually employed for acute anterior shoulder dislocation to restore (reduce) the normal anatomical position of the humeral head joint surface with the joint surface of the glenoid.
  • Surgery: If the fracture has led to the displacement of the bones, then surgery may be required to correct and fix them with pins, plates, or screws.
  • Physical Therapy: Post-surgery, physical therapy will be recommended to aid in the recovery and improve range-of-motion and strength of the arm.

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