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A Pulseless Extremity Following an Apparently Nondisplaced Proximal Humeral Physeal FractureA Case Report
Justin M. Hall, MD1; Jeffrey R. Sawyer, MD1; William C. Warner, Jr., MD1; Alice Moisan, RN1; Derek M. Kelly, MD1
1 University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery, 1211 Union Avenue, Suite 510, Memphis, TN 38104. E-mail address for D.M. Kelly: dkelly@campbellclinic.com
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Investigation performed at the University of Tennessee-Campbell Clinic Department of Orthopaedic Surgery and Le Bonheur Children’s Hospital, Memphis, Tennessee



Disclosure: None of the authors received payments or services, either directly or indirectly (i.e., via his or her institution), from a third party in support of any aspect of this work. One or more of the authors, or his or her institution, has had a financial relationship, in the thirty-six months prior to submission of this work, with an entity in the biomedical arena that could be perceived to influence or have the potential to influence what is written in this work. No author has had any other relationships, or has engaged in any other activities, that could be perceived to influence or have the potential to influence what is written in this work. The complete Disclosures of Potential Conflicts of Interest submitted by authors are always provided with the online version of the article.

Copyright © 2013 by The Journal of Bone and Joint Surgery, Inc.
JBJS Case Connector, 2013 Sep 11;3(3):e90 1-4. doi: 10.2106/JBJS.CC.L.00274
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Extract

This case report describes a pediatric physeal fracture that was notable because axillary artery entrapment developed as a result of a Salter-Harris type-II fracture of the proximal part of the humerus even though the fracture appeared to be nondisplaced on radiographs. To our knowledge, this is the first reported case of this type of injury in the English-language literature; it highlights the need for careful neurovascular examination of all patients with fractures, even those that appear to be minimally displaced or nondisplaced. The patient and her parent were informed that data concerning the case would be submitted for publication, and consent was provided in accordance with the requirements of our institutional review board.
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    Accreditation Statement
    These activities have been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of the American Academy of Orthopaedic Surgeons and The Journal of Bone and Joint Surgery, Inc. The American Academy of Orthopaedic Surgeons is accredited by the ACCME to provide continuing medical education for physicians.
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