What is the primary treatment for proximal humeral epiphysiolysis?

The primary treatment for proximal humeral epiphysiolysis, which is often seen in young athletes, particularly baseball players, involves rest from throwing for an appropriate duration, typically around three months. This condition arises due to repetitive stress on the growing epiphyseal plate, leading to its separation or injury. The initial management focuses on allowing the bone and surrounding soft tissues to heal naturally without the added stress of throwing activities.

Resting from throwing enables the epiphyseal plate to recover and reduces inflammation and pain associated with the condition. During this period, it is essential to avoid exacerbating the injury through continued stress from activities that involve overhead movements. While options like physical therapy can be beneficial for rehabilitation after the initial healing phase, they are not the primary treatment for the condition itself at the onset.

Immediate surgery is typically reserved for cases with significant displacement or associated complications, which are less common. Therapeutic injections may provide relief in certain scenarios, but they are not a first-line treatment for proximal humeral epiphysiolysis, especially in a growing athlete. Therefore, the emphasis on rest from throwing for three months serves as the most effective primary treatment to facilitate proper healing of the injury.