Luxatio Erecta (Inferior Glenohumeral Joint Dislocation) with Growth Plate Fracture of Proximal Humerus: Case Report of Surgical Treatment in an Adolescent Patient

Fractures involving the growth cartilage of the proximal humerus are uncommon in pediatric traumatology, accounting for only about 5% of all pediatric fractures. The most widely used classification systems in this field are those specifically designed for the pediatric population: the Salter-Harris classification and the Neer and Horwitz classification. This type of trauma is usually not associated with other joint injuries; therefore, a variety of treatment approaches are adopted for its management. Even rarer are glenohumeral fracture-dislocations in this patient population, and consequently, there are few clinical studies or reports available in the current literature. We present the case of A and B, a 13-year-old right-handed male, who sustained thoraco- abdominal and right upper limb trauma following a bicycle fall at approximately 30 km/h. The patient was admitted to the Emergency Department of our hospital with an inferior glenohumeral dislocation (Luxatio Erecta). A CT scan performed after the reduction of the dislocation revealed a displaced fracture of the proximal right humerus involving the articular cartilage. Due to the type of fracture, an emergency Closed Reduction and Internal Fixation (CRIF) using Kirschner wires was performed. Clinical and radiographic follow-up at 1,3,6 and 12 months showed good bone healing and functional recovery of the limb. The current literature remains divided regarding the optimal treatment for these injuries. While there is consensus favoring conservative treatment in patients under 5 years of age, the recommendations for older pediatric patients are less clear. Furthermore, there are few descriptions of the surgical techniques used for reduction and fixation in such cases. The objective of this report is to provide a detailed description of the diagnostic and therapeutic process, to compare it with the available literature, and done a valid reference for the management of similar injuries.