Outcomes of Percutaneous Pinning Technique in the Management of Two-Part and Three-Part Proximal Humerus Fracture in Adults

Abstract

Background: Proximal humerus fractures represent 4-5% of over-all fractures. In patients above 40 years of age, it accounts for 75% of all humerus fractures. Fractures of the proximal end of the humerus oftentimes represent a management dilemma with the multiple surgical options available to deal with them. Objective: To evaluate the functional and radiographic outcomes of the percutaneous pinning techniques in the management of two-part and three-part proximal humerus fracture. Patients and Methods: A case series of 25 patients, functional outcome was determined by ASES and Constant scores and multiple radiographic views were taken to assess the fracture union, mal-union, and the presence of avascular necrosis. Results: ASES score of the whole group was 87.27 while the mean Constant score was 79.04. Only 16% of the entire group developed varus malunion (defined by Neck-Shaft-Angle <=120degrees). Moreover, 16% of the whole group developed OA of the glenohumeral joint. Conclusion: This study supports that the percutaneous close reduction and pinning technique is an effective and reliable surgical technique in the management of closed two-part and three-part proximal humerus fractures in adults. Appropriate preoperative planning is important to achieve a successful surgical result, and regular postoperative follow-up and rehabilitation are essential to get an optimum functional outcome. Keywords: Proximal humerus fracture, percutaneous pinning, upper extremity surgery, trauma surgery, Clinical outcomes, Percutaneous fracture fixation