Epiphyseal Separation of the Proximal Humerus in a Newborn

Joana Novais Costa*, João David Costa, Fernando Macedo, Miguel Rocha, João Lucas, Rui Cerqueira, Fernando Lima

Department of Orthopedics, Hospital Senhora Da Oliveira, Guimarães, Portugal

*Corresponding Author: Joana Novais Costa, Department of Orthopedics, Hospital Senhora Da Oliveira, Guimarães, Portugal.

Received: June 01, 2023; Published: August 15, 2023

Abstract

Background:Epiphyseal detachment of the proximal humerus is a rare injury that can occur in traumatic labor. Conservative treatment is the treatment of choice for these injuries with good outcomes.

We report a case of epiphyseal separation of the proximal humerus in a newborn and discuss the problems arising in its diagnosis reviewing the literature.

Case Report: Newborn, male, 28 weeks and 3 days old, cesarean section with difficult extraction. At birth he presented with an exuberant ecchymosis of the upper left limb associated with edema and reduced mobility.

The limb was in adduction and shortened and it was evident a reduced palmar grip, in comparison with the right side.

X-ray examination confirmed the position of the arm and excluded any major fractures.

Ultrasound examination demonstrated a more anterior and proximal topography of the diaphysis and the humeral head was found more posteriorly with overlap between the humeral head and the diaphysis suggesting epiphyseal detachment.

Conservative treatment was the treatment of choice. Subsequent X-ray examination showed healing of the epiphyseal separation and good alignment of the upper extremity

.

At 12 months old the patient has regained total movement and strength of the left upper extremity.

Conclusions: Epiphyseal separation of the proximal humerus should be considered in the differential diagnosis of neonates with traumatic labors who have limitations on the motion of the upper extremity. The diagnosis may be difficult to make with plain radiographs. Ultrasound on the other hand, can accurately make the diagnosis confirming the epiphyseal detachment. Conservative treatment is the treatment of choice for these injuries with very good results.

This paper describes the technique and recommends the procedure which maintains the proximal interphalangeal joint movement.

Keywords: Epiphyseal Detachment; Proximal Humerus; Neonates; Traumatic Labor

References

1. El-Adl WA., et al. “Epiphyseal separation of the proximal humerus after birth trauma”. European Journal of Orthopaedic Surgery and Traumatology 6 (2014): 863-867.
2. Goldfisher R and Amodio J. “Separation of the proximal humeral epiphysis in the newborn: rapid diagnosis with ultrasonography”. Case Reports in Pediatrics (2015): 825413.
3. Amen JF and Youssef “A Case of proximal humeral physeal separation in a newborn: Is internal fixation justified?” Journal of Musculoskeletal Surgery and Research 3 (2019): 231-234.
4. Guo JB., et al. “Fracture separation of the proximal humeral epiphysis in neonate: a case report and literature review”. Chinese Journal of Traumatology 1 (2010): 62-64.
5. Broker FH and Burbach T. “Ultrasonic diagnosis of separation of the proximal humeral epiphysis in the newborn”. The Journal of Bone and Joint Surgery. American Volume 72 (1990): 187-191.
6. Raupp , et al. “Epiphyseal separation of the distal humerus”. Journal of Perinatal Medicine 30.6 (2020): 528-530.
7. Jalili , et al. “Axillary artery injury with proximal humerus epiphyseal separation: a rare case report”. Medical Journal of The Islamic Republic of Iran 26.4 (2012): 189-191.

Citation

Citation: Joana Novais Costa., et al. “Epiphyseal Separation of the Proximal Humerus in a Newborn".Acta Scientific Orthopaedics 6.9 (2023): 21-24.

Copyright

Copyright: © 2023 Joana Novais Costa., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.