Evaluation of Percutaneous Pinning of Fractures of the Surgical Neck of the Humerus in Children and Adolescents

Abstract

Background: Open or closed reduction with Kirschner wires, screws, and flexible nails has been documented for the treatment of displaced proximal humeral fractures, however percutaneous K-wire fixation is the most widely utilized procedure.Objective: This study aimed to evaluate short-term clinical and radiographic results of percutaneous pinning of surgical neck-humerus fractures in children and adolescents using k-wire. Patients and Methods: Our study was done on 18 patients with fractures of the surgical neck of the humerus at Zagazig University Hospital treated by percutaneous pinning using k-wire. The humerus fractures were followed up clinically and radiologically for 6 months. Neer and Horwitz classification was used to classify fractures. Constant-Murley shoulder scoring system were used to evaluate results. Results: According to Constant-Murley scoring system the result obtained were excellent in 14 patient (77.78%) and good only in 4 cases (22.22%). Concerning the complications of the current study, 11 cases had no complication (61.11%), 3 cases had stiffness (16.67%) and 4 cases had superficial infection (22.22%). 4 cases of superficial infection were treated with antibiotics and daily dressing. K-wires were not required to be removed early. All of them achieved excellent results. 3 cases of stiffness were completed by physiotherapy, 2 of which yielded good results and 1 of which yielded excellent results. Conclusion:Fractures of the surgical neck in children and adolescents can be successfully treated with percutaneous kwires technique, which provides stability after reduction of fractures. Early and adequate physiotherapy program gives better results regarding the range of motion.