Closed Reduction and Percutaneous Pinning in Fracture Proximal Humerus in Children
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- Category: Vol. 82, June 2014
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Closed Reduction and Percutaneous Pinning in Fracture Proximal Humerus in Children, Abo-Bakr Z. Said and Haytham A. Abdel-Moneim
Abstract
Background: The majority of proximal humeral fractures can be treated nonoperatively in children with good clinical outcomes. However, severely displaced fractures may be treat-ed operatively to restore anatomic alignment and maximize shoulder motion especially in older children.
Objective: The purpose of this study is to assess clinical outcome and radiographic results of closed reduction and per-cutaneous pinning of proximal humeral fractures in children.
Patients and Methods: Fifteen patients with fracture prox-imal humerus treated by closed reduction and percutaneous pinning. The mean age was 12 years (range 8-15) and mean follow-up duration was 7.7 months (range 3-10). According to Neer-Horowitz classification, there were one patients with type I, five with type II, four with type III and five with type IV. All patients were evaluated by radiographs and CT preoperatively and postoperatively. The mean duration from injury to surgery was 12.75 hours (range 3-72). All cases achieved union at a mean period of 6.2 weeks (range 5-8). We assessed the out-come using a clinical score and the scoring system of Constant and Murley. A final review, the clinical results were graded as excellent in 10 patients, good in four and poor in one.
One case showed slippage of K-wires and two developed pin tract infection.
Conclusion: Closed reduction and percutaneous pinning is effective in stabilizing severely displaced proximal humerus fractures in older children with achievement of satisfactory re-sults. Full clinical and radiological union was achieved at 5 to 8 weeks regardless type of fracture or age of the child.