Proximal humerus fractures sustained during the use of restraints in adolescents

Injuries to skeletally immature individuals sustained during restraints have been rarely documented. The authors report a series of five proximal humerus fractures in skeletally immature patients (average age 15.3 years) that occurred during restraint with handcuffs. A similar mechanism of injury was identified in all of the cases. All five injuries were Salter-Harris type I or II, and three of the five required operative intervention. At short-term follow-up, all patients are doing well without evidence of growth disturbances. To the authors' knowledge, this is a unique mechanism of injury that could be avoided with proper education.