Orthopedics - Oleksa A.P. 2006

Osteochondropathies
Osteochondropathies of the bones of the upper extremity - Osteochondropathy of the humeral head

Epiphysial Osteochondropathy of the humeral HEAD is a rare condition first described by Hass in 1921. It typically affects children between five and ten years of age, predominantly boys. Patients complain of pain in the shoulder joint region, resulting in a restricted range of motion as the pain intensifies with movement.

On inspection, no visible pathological changes are observed in the shoulder area; however, the child guards the arm and cannot raise it freely or abruptly. Palpation reveals that the pain is localized to the intertubercular groove of the humerus.

Comparative radiographs of the shoulder joints in two projections reveal serration and flattening of the epiphysis of the affected shoulder, increased bone density (pseudosclerosis) in the subchondral region of the head, and, during the fragmentation stage, radiolucencies resembling small cysts in this area. The joint space may be slightly widened.

Laboratory Blood tests and computed tomography of the humeral head in the epiphyseal region play a major role in Differential Diagnosis.

Treatment. To immobilize and rest the shoulder joint, a plaster splint is applied with the arm abducted on a wedge-shaped pillow. The hand remains free and preserves its basic Functions.

Since the process can be prolonged (2–3 years), the plaster splint is removed after two months, and the arm is supported in a sling with a pillow for one month. It is essential to prevent The Development of adduction contracture in the shoulder joint and progressive Muscle atrophy.

Children undergo courses of muscle massage, physical therapy, and passive movements in the Shoulder and Elbow joints. Particular attention should be paid to ensuring that the child adheres to a gentle, protective regimen during the fragmentation stage, which is monitored radiographically every six months.

With proper treatment, the humeral head will retain its anatomical shape and function.



Last update: 10/08/2026

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