Clinico-radiological outcome of closed reduction and percutaneous fixation of proximal humerus fractures

Abstract

Proximal humerus fracture is the commonest fracture affecting the shoulder girdle in adults and its incidence is rising. In displaced fractures, surgery is the treatment of choice in order to restore anatomical integrity, and allows early functional recovery. Several techniques were used over the years, each with specific indication. Closed reduction and percutaneous fixation reduces risk from soft-tissue dissection and may reduce the fracture indirectly, achieving provisional fixation for anatomic healing. Aim of study is to assess the clinic-radiological outcome of percutaneous pinning in proximal humerus fractures. A study group of 21 patients with Neer,s type 2 and 3 proximal humerus fracture were treated with closed reduction and percutaneous K-wire fixation and clinico-radiological assessment was done and functional outcome was assessed by Constant-Murley score in various follow ups. 17 patients were available for assessment with minimum follow up of 1 year (Range 1 to 6 year). Patients had a mean age group of 35.5 years. All patients except two showed full range of movement, radiographic healing occurred in a mean time of 10 week and K-wire removal was done at a mean interval of 12 weeks. Mean Constant-Murley score was found to be 85%. Percutaneous fixation by k-wires after closed reduction is a reliable option for management of 2-or 3-part proximal humerus fractures which also avoids plate application.