Proximal Humerus Growth Plate Fracture

A growth plate fracture, or epiphysis plate fracture, occurs at the end of a bone in children before the bone has fully turned from cartilage to hard bone.


A proximal humerus fracture occurs in the upper arm, near the shoulder, and is normally caused by a hard impact like a fall. There will be severe pain and swelling in the upper arm and movement will be difficult.

A growth plate fracture is usually caused by a fall or impact on the arm or shoulder, although it can occur in parts of the body through overuse.


Symptoms include sudden pain in the upper arm and shoulder at the time of injury with rapid swelling in the shoulder. Attempting to move the arm will be painful and it is possible the shoulder joint may appear deformed.

Long bones such as the Humerus grow from the ends. At each end, there is a growth (or epiphyseal) plate which is the last part of the bone to harden from cartilage. For this reason, it is the most susceptible area to injury.

Growth plate fractures occur in children and adolescents. This area is rarely injured in adults as the ligaments and other soft tissues surrounding the joint are stronger in a child than the soft bone is. This results in the bone being the first casualty! In adults, the soft tissue is more likely to be injured.


If a fracture is suspected, immobilize the arm and seek medical attention as soon as possible. An X-ray or MRI will be taken to confirm the diagnosis and the amount of displacement of the bones. Non-displaced injuries may be treated conservatively with a period of immobilization to allow healing, followed by rehabilitation to regain full strength and movement.

Fractures, where the two bones are separated or misaligned, may require surgery. Surgery aims to realign the bones and fix them in place using pins or wires. Immobilization is again required to allow healing and should also be followed by rehabilitation.

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