Closed reduction and percutaneous pinning in three-part fractures of the proximal humerus

ABSTRACT

Three and four- part fractures of the proximal humerus occurring in the elderly population usually result from low energy trauma in osteoporotic patients. Closed reduction and percutaneous fixation of three- part fractures may offer a stable fixation to allow early rehabilitation. An attempt is made to study the results of this minimally invasive procedure. Thirty patients with three- part fractures of the proximal humerus were treated with closed reduction and percutaneous pinning of the shoulder. All patients were above 50 years of age. They were seventeen women and thirteen men. Patients were followed for a minimum of six months after surgery. Physiotherapy was initiated on the second day after surgery. The results were evaluated radiographically for union and clinically for pain and range of motion. The results were evaluated using the Constant score and the complications were minimal. The average Constant score was 80 at six months postoperatively. The procedure is minimally invasive in this old age group and offers an alternative to the more invasive open procedures. This study demonstrates that this procedure provides very good results with very little complications