Minimally Invasive Treatment for Severely Displaced Proximal Humeral Fractures in Children Using Titanium Elastic Nails

Abstract

To evaluate the preliminary results of minimally invasive treatment for severely displaced proximal humeral fractures in children using titanium elastic nails (TENs). Twenty-five cases of TEN treatment of severely displaced proximal humerus fractures in children were evaluated clinically and radiographically. Complications were assessed. The 14 males and 11 females were between 6 and 15 years of age at the time of surgery. Of the 10 left and 15 right humeri treated, 3 were open fractures and 2 were associated with polytrauma. Two laterally inserted retrograde TENs were used in 22 cases. In the remaining 3 cases, 1 medial and 1 lateral TEN were inserted retrograde. Follow-up ranged from 7 to 40 months. All fractures showed both clinical and radiographic evidence of healing within 2 months. There were no major complications related to the treatment. There were 3 cases of skin irritation adjacent to prominent distal ends of the nails, of which the 2 nails in 1 child were removed prematurely at 3 weeks without sequelae. The nails in the other 2 cases were removed at the planned 6-month postoperative time with complete resolution of symptoms. Function of the fractured arm returned to normal quickly in all cases. TEN for the treatment of severely displaced humerus fractures in children is an effective method with a low complication rate.