Percutaneous fixation for displaced proximal humeral fractures in adolescents and young adults

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Abstract

Background
Closed reduction and percutaneous pinning of proximal humerus fractures is a reliable method for stable fixation in certain patients. Although it is less rigid biomechanically than plate and screw constructs, percutaneous pinning may be used in patients younger than 45 years of age with good bone quality and noncomminuted fracture fragments.
Patients and methods
Twenty-three patients with displaced proximal humeral fractures (after high-energy trauma), mean age 26.4 years (range 14–45 years), were treated by closed (nine patients) or open (14 patients) reduction and percutaneous pinning with smooth pins. Pins were removed after 6–8 weeks and followed up for a mean of 6.7 months (range 6–14 months).
Objectives
Evaluation of the results of treatment of displaced surgical neck fractures in adolescents and young adults.
Results
According to the Constant scoring system, the mean score was 89.65 points. Seventeen patients (73.9%) had an excellent score, three patients (13%) had a good score, and three patients (13%) had a fair and poor score. Twenty patients (87%) were satisfied with the result of the treatment and three patients (13%) were not satisfied.
Conclusion
Displaced proximal humeral fractures could be treated by closed or open reduction and percutaneous pinning, yielding good fracture positioning and adequate temporary stabilization. No major complications such as avascular necrosis, nonunion, deep infection, or neurovascular deficit were associated with this method of treatment.

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