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

Abstract

Proximal humerus fracture with simultaneous shoulder dislocation in children is a rare occurrence, with few reported cases. This systematic review of case reports aimed to document the outcomes of different treatment methods. A comprehensive literature search from 1980 to 2024 included case reports on traumatic shoulder fracture-dislocation in children. Eighteen studies were included, with a mean follow-up of 1.5 years. The cases comprised 7 boys and 11 girls, aged between 11 months and 16 years (median 6 years). The cases were divided into two groups based on epiphyseal involvement. Group A had 11 cases (61%) with epiphyseal involvement, while Group B had 7 cases (38%) with metaphyseal fractures without epiphyseal involvement. Treatments included closed or open reduction, with or without internal fixation. All fractures healed in an average of 7 weeks, with full function restored in an average of 21.58 weeks. The review suggests that open reduction with K-wire fixation is optimal for Group A, whereas closed reduction with intramedullary fixation is more effective for Group B, offering satisfactory clinical and radiological results in a shorter time efficiently.