Working Diagnosis:
Proximal humerus fracture with buckle appearance
Treatment:
The patient was placed in a sling for comfort. She was prescribed non-NSAID pain control.
Outcome:
Early range of motion exercises
Repeat x-rays at 1 week and 3 weeks
No gymnastics, dancing, or gym for at least 3 weeks
At 3 weeks, gradual progressive return to activity
At 6 weeks, full activity which she tolerated well
Editor's Comments:
In pediatric age athletes buckle fractures should always be considered after trauma. Physeal fracture, Salter Harris classification are also very common. In this case, traumatic impingement and ligamentous sprain should also be in the differential.
References:
Mathison, D and Agrawal, D. (2017, July). General principles of fracture management: Fracture patterns and description in children accessed from Uptodate online 1/4/2018.
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