Closed percutaneous K-wire stabilization for fractures of the proximal humerus

Lee, Dong Wha; Shin, Kyoo Seok; Kim, Jei Bum

Abstract

PURPOSE: The purpose of this study is to analyze the result and complications of treatment using percutaneous K-wire stabilization for fractures of the proximal humerus. MATERIALS & METHOD: To be eligible for the study, total 12 patients of displaced two, three or four part fractures of the proximal humerus were treated, 10 females and 2 males with a mean age of 52 years (range 18-76 year). Reduction was obtained by longitudinal traction combined with posterior pressure on the humeral shaft. After reduction, minimum two 2.5mm terminal threaded pin or smooth tip K-wire was inserted.
RESULTS
Union rate of 83.3% was observed at an average 2.7 months. Range of motion of shoulder was 125 degrees of forward flexion, 114 degrees of abduction. Patients of 83.3% had good or excellent functional result. Four patients had a mild, superficial pin tract infection associated with loosening of the pin. The infections resolved with removal of pin and oral antibiotics. Valgus deformity was developed in a patient however the patient subsequently had a good functional result and nonunion were developed in two cases.
CONCLUSION
The technique of closed reduction and percutaneous pinning is quite demanding procedure, although it may appear to be deceptively simples. The good indications for the use of this procedure seems to patients with severe comminuted fractures, old age with osteoporosis. For the more rigid fixation, terminally threaded pins should be used, not smooth pin.