Introduction:  

• 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*

Complications:

• 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

• PEM Currents
• Orthobullets