{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:43:19Z","timestamp":1787755399276,"version":"build-2784847793"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Case:<\/jats:title>\n                    <jats:p>A 9-month-old infant girl with Down syndrome presented with an atrophic nonunion of the right humerus diaphysis secondary to birth trauma. Surgical intervention included open reduction and external fixation plus cadaveric cancellous bone allograft and platelet-rich plasma and then was changed to an external fixator in axial compression. At 16 months after surgery, bone healing was achieved.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Nonunions in infants are rare, and their treatment is a challenge; an adequate vascular supply with good stabilization and reduction are keys to management. We believe that the improvement in reduction and stability under axial compression were the keys to achieve consolidation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.2106\/jbjs.cc.22.00764","type":"journal-article","created":{"date-parts":[[2023,4,18]],"date-time":"2023-04-18T14:03:58Z","timestamp":1681826638000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":1,"title":["Nonunion of Diaphyseal Humerus Fracture in an Infant"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9965-4332","authenticated-orcid":false,"given":"Luis","family":"Bera\u00fan-Coronel","sequence":"first","affiliation":[{"name":"Division of Orthopaedic Surgery, Hospital II-2 Tarapoto, Tarapoto, Peru"},{"name":"Faculty of Medicine, Universidad Nacional de San Mart\u00edn, Tarapoto, Peru"},{"name":"Postgraduate Department, Faculty of Medicine, Universidad de San Mart\u00edn de Porres, Lima, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6048-388X","authenticated-orcid":false,"given":"Jhanella","family":"Cardenas-Escalante","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad Nacional de San Mart\u00edn, Tarapoto, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6070-4956","authenticated-orcid":false,"given":"Diego A.","family":"Sinti-Paredes","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad Nacional de San Mart\u00edn, Tarapoto, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3867-7696","authenticated-orcid":false,"given":"Fredy","family":"Chamorro-Robles","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Hospital II-2 Tarapoto, Tarapoto, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9429-5895","authenticated-orcid":false,"given":"William","family":"Porres-Varona","sequence":"additional","affiliation":[{"name":"Division of Orthopaedic Surgery, Hospital II-2 Tarapoto, Tarapoto, Peru"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,4]]},"reference":[{"issue":"1","key":"bib1-20240731","doi-asserted-by":"crossref","first-page":"840","DOI":"10.1186\/s12891-020-03856-4","article-title":"The epidemiology of infant shaft fractures of femur or humerus by incidence, birth, accidents, and other causes","volume":"21","author":"Von Heideken","year":"2020","journal-title":"BMC Musculoskelet Disord."},{"issue":"4","key":"bib2-20240731","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/j.hcl.2007.09.002","article-title":"Proximal humerus and humeral shaft fractures in children","volume":"23","author":"Shrader","year":"2007","journal-title":"Hand Clin."},{"issue":"1","key":"bib3-20240731","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1097\/BPO.0b013e3181558c67","article-title":"Remodeling of birth fractures of the humeral diaphysis","volume":"28","author":"Husain","year":"2008","journal-title":"J Pediatr Orthop."},{"issue":"2","key":"bib4-20240731","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s00068-021-01613-3","article-title":"Failure analysis and recommendations for treatment of posttraumatic non-unions of the distal humerus during childhood","volume":"47","author":"Sommerfeldt","year":"2021","journal-title":"Eur J Trauma Emerg Surg."},{"issue":"4","key":"bib5-20240731","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s11832-013-0521-8","article-title":"The risk of non-union per fracture in children","volume":"7","author":"Mills","year":"2013","journal-title":"J Child Orthop."},{"issue":"12","key":"bib6-20240731","doi-asserted-by":"crossref","first-page":"2845","DOI":"10.3390\/ijerph15122845","article-title":"Incidence, costs and predictors of non-union, delayed union and mal-union following long bone fracture","volume":"15","author":"Ekegren","year":"2018","journal-title":"Int J Environ Res Public Health."},{"issue":"7","key":"bib7-20240731","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1007\/s00198-010-1443-7","article-title":"Bone mass in male and female children and adolescents with Down syndrome","volume":"22","author":"Gonz\u00e1lez-Ag\u00fcero","year":"2011","journal-title":"Osteoporos Int."},{"key":"bib8-20240731","doi-asserted-by":"crossref","first-page":"116471","DOI":"10.1016\/j.bone.2022.116471","article-title":"Low bone mass and impaired fracture healing in mouse models of Trisomy21 (Down syndrome)","volume":"162","author":"Sherman","year":"2022","journal-title":"Bone."},{"issue":"1","key":"bib9-20240731","doi-asserted-by":"crossref","first-page":"44","DOI":"10.4103\/2249-4847.92230","article-title":"Bilateral humerus fracture following birth trauma","volume":"1","author":"Dias","year":"2012","journal-title":"J Clin Neonatol."},{"issue":"9-10","key":"bib10-20240731","doi-asserted-by":"crossref","first-page":"494","DOI":"10.1007\/s00402-002-0439-y","article-title":"Occurrence and treatment of nonunion in long bone fractures in children","volume":"122","author":"Arslan","year":"2002","journal-title":"Arch Orthop Trauma Surg."},{"issue":"6","key":"bib11-20240731","doi-asserted-by":"crossref","first-page":"410","DOI":"10.3928\/01477447-20090511-11","article-title":"Nonunion of fractures in pediatric patients: 15-year experience at a level I trauma center","volume":"32","author":"Shrader","year":"2009","journal-title":"Orthopedics."},{"issue":"2","key":"bib12-20240731","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1007\/s00068-021-01613-3","article-title":"Failure analysis and recommendations for treatment of posttraumatic non-unions of the distal humerus during childhood","volume":"47","author":"Sommerfeldt","year":"2021","journal-title":"Eur J Trauma Emerg Surg."}],"container-title":["JBJS Case Connector"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00764","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:42:21Z","timestamp":1787751741000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.CC.22.00764"}},"subtitle":["A Case Report"],"short-title":[],"issued":{"date-parts":[[2023,4]]},"references-count":12,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.cc.22.00764","relation":{},"ISSN":["2160-3251"],"issn-type":[{"value":"2160-3251","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,4]]}}}