Pediatric Humerus

Posted on: April 18, 2020, by :


  • Proximal: Relatively common physeal and metaphyseal fracture seen in children with a peak age of 15 years.
    • Salter-Harris 1 is most frequent in <5 yo
    • Salter-Harris 2 is most frequent in >12 yo
    • Metaphyseal Fractures tend to be in 5-12 yo
  • Shaft: mostly traumatic but occasionally from non-accidental trauma.
    • Up to 5% with radial nerve palsy
  • Distal: *see elbow module for details*


  • Axillary nerve injuries (<1%) usually are neuropraxias
    • associated with a medially displaced shaft
  • Radial nerve injuries (<5%) usually are neuropraxias
    • associated with a middle or distal 1/3 shaft

Alternative Diagnosis:

  • Little League Shoulder
    • Overuse injury in throwers that may show minimal physeal widening (NOT A FRACTURE)
    • Consider obtaining comparison view of contralateral shoulder

    • Treatment: Nonoperative
      • refrain from pitching for 3 months and begin PT. May start progressive throwing program once symptoms resolved
Pitch Count Recommendations
Age (years of age)  Pitches per Game Max Games per Week
8-10 yrs. 52 2
11-12 yrs. 68 2
13-14 yrs. 76 2
15-16 yrs. 91 2
17-18 yrs. 106 2

 Other Helpful Resources

Haroon Shaukat MD

Pediatric Emergency Medicine Attending at Children's National Health System
I was born and raised in Silver Spring, Maryland, but with very little knowledge of all things DC. “Crabs and football, that’s what Maryland does”, unfortunately I could only partake in one of those. I grew up with a crab allergy so blue crabs are a make believe creature to me, much like the lochness monster. I decided to take the leap of faith and attend medical school abroad but family and home could not keep me away for too long. Residency took me to New Jersey where I began to cultivate my love for medical education and low tolerance for poor pain control. Did I mention I also learned that I outgrew my crab allergy in NJ! Alas, to the DMV I return! Hopefully to contribute to medical education and quality improvement while feasting on a Maryland blue crab or two.
Haroon Shaukat MD

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