Hashem Abdulrahim BUKHARY
Annals of Clinical and Analytical Medicine - 2026;17(6):627-630
Introduction: Fractures of the proximal humerus in children are relatively rare, and the management of Neer-Horwitz grade IV injuries remains controversial. Case Presentation: We report a case of a 9-year-old pediatric patient with a high Injury Severity Score (ISS) who sustained a severely displaced proximal humerus fracture following a motor vehicle collision. The case highlights that conservative management is a proper option for polytrauma patients with high-grade displacement and high ISS, emphasizing the importance of careful clinical judgment and individualized treatment decisions. Conclusion: When an explicit risk-benefit assessment favors deferring or even withdrawing surgery in the context of associated injuries, it underscores the importance of individualized, context-driven clinical decision-making.
