Nicastro J F, Adair D M
J Pediatr Orthop. 1982 Oct;2(4):427-9. doi: 10.1097/01241398-198210000-00015.
A case of fracture-separation and dislocation of the proximal humeral epiphysis, a rare injury, is reported. The patient, a 32-month-old girl suspected of being an abused child, was reported to have fallen from her crib 2 days earlier. She had a painful, swollen, slightly ecchymotic left shoulder, which she held in the neutral position and refused to move. Radiographs showed a healing, nondisplaced radial fracture and fracture-separation of the proximal humeral epiphysis, which was dislocated into an anterior subglenoid location. Surgery under general anesthesia showed the humeral head to lie in a subglenoid position and the distal fragment of the separated epiphysis to have penetrated the posterior lateral capsule. The reduction was stabilized with a single, percutaneous, smooth Kirschner wire and shoulder immobilized in a Velpeau cast for 3 weeks. At 2 year follow-up, the patient has painless, full range of motion, the epiphysis is open, and the length of the humerous appears normal.
报告了一例肱骨近端骨骺骨折分离并脱位的病例，这是一种罕见的损伤。患者为一名32个月大的女童，疑似受虐儿童，据报告2天前从婴儿床摔下。她左肩部疼痛、肿胀，略有瘀斑，肩部保持中立位，拒绝活动。X线片显示桡骨骨折已愈合且无移位，肱骨近端骨骺骨折分离，脱位至肩胛下前方位置。全身麻醉下手术显示肱骨头位于肩胛下位置，分离骨骺的远端碎片穿透后侧关节囊。通过一根经皮光滑克氏针进行复位固定，肩部用Velpeau绷带固定3周。随访2年时，患者肩部无痛，活动范围正常，骨骺未闭合，肱骨长度看起来正常。
