A-prospective study of the outcome of closed intramedullary fixation of humeral shaft fractures treated with multiple K-wires in adults

Abstract

To evaluate the feasibility and efficacy of management of fracture of shaft humerus in adults by closed reduction internal fixation with the help of long K-wires followed by immobilization for 3 weeks in splint and then guarded mobilization till fracture united. Methods: This was a prospective longitudinal study. The subjects with fresh diaphyseal humeral shaft fractures without injury to the same limb, transverse/oblique fractures with a large butterfly fragment, comminuted fractures/segmental fragments and long oblique or spiral fracture were included in the study. Patient was taken on the table in lateral position. The general anaesthesia was given. A midline vertical incision of about 3 cms was given on the posterior aspect of distal humerus and the soft tissue dissected. Triceps was split in line with the fibres and the bone was reached. Results: The mean age of the patients was 42.13 (±13.02) years. More than half (69.6%) of the subjects were male. The RTA was among 65.2% of the subjects. The oblique with butterfly type of injury was in 30.4% of the subjects and comminuted was in 21.7%. The middle site of fracture was in 52.2% and left site of fracture was in 52.2%. The antegrade nailing was used among 69.6% of the patients. There was significant increase in the extent of union, constant score and Mayo score from 4 week to 8 and 12 week. The shoulder stiffness was among 65.2% at 4 week which became 13% at 8 and 12 week. The elbow stiffness was in 17.4% of the subjects which decreased to 13% and 8.7% at 8 and 12 week respectively. Conclusion:The present study showed that K-wire fixation for humeral shaft fractures has distinct advantages over other conservative and over operative techniques.

Outcomes of the Treatment of Humeral Shaft Fractures by Closed Reduction and Internal Fixation With Multiple Intramedullary Kirschner Wires (K-wires)

“…Achieving a full range of motion for the elbow in all participants is another positive outcome, as it is essential for functional recovery. These findings are in line with the prospective study, which found excellent elbow movements in 93% of patients [13].…”

“…The majority of fractures in this study were transverse or oblique (77.8%), with spiral fractures being less common (22.2%). These findings can be compared with a prospective study, which typically describes transverse or oblique with butterfly fractures as the most common types of humeral shaft fractures [ 13 ]. The location, nature, and degree of the impact that caused the fracture determine the fracture type.…”