Prospective study to evaluate the benefits of percutaneous K-wires system in Proximal Humeral Fractures in Elderly Population: Our Experience

Abstract

Introduction: Proximal humeral fractures are extremely common injuries. The incidence of fracture of the proximal humerus is bimodal in geriatric due to osteoporosis and in adolescents due to high-energy trauma. Recent trends are shifting away from open reduction and massive internal fixation (by plates and screws) toward closed reduction and percutaneous fixation as this method is less invasive soft tissue damage and minimal risk of iatrogenic avascular necrosis. The purpose of this study was, to preserve the biological integrity of the humeral head and to secure anatomical reduction with multiple k wires with angular stability also improve stability of fixation osteoporotic humeral bones.

Material and methods: A prospective study was performed on all patients diagnosed with intra-articular proximal humerus fracture presenting to us from Nov 2018 to June 2022. Only patients with closed, displaced two or three part fractures as per Neer’s classification were included in the study. Fractures were managed by close reduction and percutaneous pinning with K wires and some cases which were linked by a fixator rod using clamps.

Results: Twenty patients comprising of 12 females and 08 males were followed for an average period of 12 months. Mean age of the patients was 58 years. Fall was the most common mode of injury in 15 patients followed RTA injury in 5 patients. All patients achieved full functional range of motion by the end of 4 months. Out of Twenty patients 06 (30%) patients showing excellent results, 12 (60%) patients having good results, and 02(10%) patients having fair results, no patient having poor result.

Conclusion: percutaneous K wire fixation using the external fixator mini clamps and rods is an effective and economical method allowing biological preservation with good results.