Functional outcome of percutaneous Kirschner wire fixation of proximal humerus fractures

Abstract

Proximal humerus fractures are prevalent in both elderly and young patients and can be managed with a variety of treatment options ranging from conservative management to arthroplasty. Due to frequent injury to blood supply of humeral head and various other anatomic considerations, no treatment modality gives good results in all patients. 20 patients with proximal humerus fracture were treated with Closed Reduction and K-wire fixation in and were followed up for a period of 6 months. Functional outcome was measured with Constant Murley score and modified UCLA score. Out of 20, 17 patients were available for follow up and final analysis. 9 patients had 3 part, 2 patients had 2 part and 6 patients had 4 part fractures as per Neer’s Classification. According to AO/OTA classification, 13 patients had Type B fracture, 2 had Type A fracture and 2 patients had Type C fracture. Average age of the group was 61.76 years with an average time to union of 6.18 weeks. 13 out of 17 patients had good to excellent results according to Constant Murley score with an average score of 65.47 while 9 out of 17 patients had good to excellent results as per modified UCLA score. Most common complication was loosening of K wires. Closed reduction and K-wire fixation of proximal humerus fracture has satisfactory results with good functional outcome in majority of patients. It has several advantages over open methods of fixation especially in elderly patients as it is less invasive and biological environment of the fracture is maintained. We conclude that Closed Reduction and K-wire fixation is a good alternative to open methods of fixation in treatment of 2 part, 3 part fractures and in certain 4 part fractures.