Bilateral Traumatic Proximal Humeral Physeal Fracture in an Adolescent Child – A Rare Case Report and Review of Literature

INTRODUCTION: Proximal humerus fractures in the pediatric population are relatively uncommon accounting for <3% of all the fractures. Being the growing end of the bone, these fractures have a high threshold for conservative management. Dilemma does exist when such a fracture occurs in a borderline adolescent age group. Occurrence of bilateral physeal fractures in the same anatomical location is exceedingly rare and such a case of bilateral traumatic physeal fracture of proximal humerus has not been reported in the literature. CASE PRESENTATION: A 14-year-old male child presented with post-traumatic pain and swelling of both the shoulders. Radiographs revealed displaced proximal humerus physeal fracture bilaterally. The displaced fracture was treated with closed reduction and percutaneous fixation using smooth Kirschner wires and cannulated screw. CONCLUSION: Considering the bilateral nature of the injury and a borderline age with limited remodeling potential, a lower threshold for conservative therapy must be adopted in young active individuals. High-velocity trauma does form a major cause of such bilateral injuries, however, nutritional deficiencies and metabolic causes should be kept in mind while treating such a rare pattern of injury.