Shoulder dislocation combined with proximal humerus fracture in children: A case report and literature review.

RATIONALE: Proximal humerus fracture occuring simultaneously with dislocation of a shoulder in children is extremely rare, with only a few recent reports of on such cases having been reported.

PATIENT CONCERNS: A 6-year-old girl fell from a ladder and landed on her dominant right arm with pain in the right shoulder and unable to perform movements; her shoulder did not allow for passive movements as well.

DIAGNOSES: Proximal humerus fracture combined with shoulder dislocation.

INTERVENTIONS: The patient was treated with open reduction, elastic stable intramedullary nail (ESIN) fixation, immobilization with U-shape cast and shoulder spica brace.

OUTCOMES: The patient was pain-free, with full range movement of the injured shoulder and no sign of avascular necrosis in a 2-year follow-up period.

LESSONS: We recommend open reduction with ESIN fixation for severely displaced proximal humeral metaphyseal fractures with shoulder dislocation in children. Preoperative bilateral anteroposterior shoulders x-ray is needed to confirm the shoulder location.