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Segmental Metadiaphyseal Humeral Bone Loss in Pediatric Trauma Patients: A Case Series

Wimberly, Robert L. MD*,†; Wilson, Philip L. MD*,†; Ezaki, Marybeth MD*; Martin, Benjamin D. MD; Riccio, Anthony I. MD*,†

Journal of Pediatric Orthopaedics:
doi: 10.1097/BPO.0000000000000131
Trauma
Abstract

Background: The management of posttraumatic bone loss is complicated and often requires complex reconstructive procedures. No options exist that are specific to the treatment of the growing skeleton that has intercalary bone loss. We have observed reconstitution of the humerus in 2 cases that have precluded extensive management.

Methods: Two pediatric patients sustained traumatic injuries to the upper extremities, including humeral bone loss, and are presented after spontaneous reconstitution of the segmental bone loss.

Results: With treatment restricted to soft-tissue injury and bone stabilization with external fixation, both patients demonstrated radiographic healing of humeral segmental bone loss. Both patients were thought to have a partially intact periosteal sleeve. They have returned to sporting activities with mild loss of function.

Conclusions: In certain pediatric injuries, spontaneous healing of segmental bone defects can occur. This response may obviate the need for complex, interventional procedures.

Levels of Evidence: Level IV—case series.

Author Information

*Texas Scottish Rite Hospital for Children

Children’s Medical Center Dallas, Dallas, TX

Children’s National Medical Center, Washington, DC

None of the authors received financial support for this study

The authors declare no conflicts of interest.

Reprints: Robert L. Wimberly, MD, Texas Scottish Rite Hospital, 2222 Welborn St., Dallas, TX 75219. E-mail: lane.wimberly@childrens.com.

© 2014 by Lippincott Williams & Wilkins