Management of traumatic fracture–dislocation of the shoulder in children: A systematic review of published case reports

Abstract

Purpose Proximal humerus fracture occurring simultaneously with shoulder dislocation in children is extremely rare, with only a few reports of such cases having been reported. A systematic review of case reports was conducted to document outcomes after different treatment methods. Methods A systematic search of literature from 1980 to 2021 was performed from the PubMed/Medline, ScienceDirect, and SCOPUS databases. All case reports on traumatic fracture dislocation of the shoulder in children were included. Results A total of 18 studies were included with a mean follow-up of 1.5 years. There were 7 boys and 11 girls with an age range from 11 months to 16 years with a median of 6 years. These cases were grouped into two, based on the involvement of the epiphysis with fracture–dislocations. In group A, there were 11 cases (61%) of shoulder dislocation involving the epiphysis. While in group B, there were seven (38%) cases with fracture metaphysis but not involving the epiphysis. Both groups were treated by closed or open reduction with or without internal fixation. All fractures healed in a mean of 7 weeks while the full function was achieved in an average of 21.58 weeks. Conclusion This systemic review supports the treatment of patients in group A by open reduction with K-wire fixation. While in group B, closed reduction with intramedullary fixation is a better option as it provides satisfactory clinical and radiological results in a short time.