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Key Features

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  • Injury with significant fall on outstretched arm

  • Severe pain in proximal humerus

  • Tenderness, swelling, and/or deformity over proximal humerus

  • Fractures can include the physes or may be extraphyseal

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Clinical Findings

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  • Pain and swelling are localized to the proximal humeral region

  • A significant amount of displacement and angulation can be tolerated in this location because of the young athlete's potential for remodeling and because of the intrinsic range of motion of the shoulder

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Diagnosis

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  • Careful assessment of the brachial plexus and radial nerves are needed to rule out associated nerve damage

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Treatment

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  • Consists of a sling for 4–6 weeks followed by progressive rehabilitation with return to play at 8–12 weeks when bony healing, full range of motion, and strength have been achieved

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