Percutaneous Multi-angle Thread Needle for Two- or Three-part Unstable Fractures of the Proximal Humerus in Older Population.

Abstract

This study aimed to evaluate the clinical functional and radiological outcomes of percutaneous repositioning with multi-angle thread needles in older patients with two- or three-part displaced fractures of the proximal humerus. About 48 patients treated with multi-angle thread needles for two- or three-part displaced fractures of the proximal humerus were enrolled. The patients were followed up for 12 to 24 months (with an average follow-up of 18 months). Imaging examinations were performed at week 4, week 8, week 12, month 6, and year 1 postoperation. The functional and radiological outcomes, including the fracture healing time, American Shoulder and Elbow Surgeons Association (ASES) score, Constant-Murley score, and visual analog score questionnaire, were followed up and assessed. The fracture healing time was 14.6 weeks (12-41 weeks). The interval from the end of surgery to the resumption of functional shoulder exercise was 16.2 weeks (14-36 weeks), and all the fractures healed by the last follow-up. The ASES score, the average Constant-Murley score, and the VAS pain score at the 1-year postoperative follow-up were 88.9 ± 9.6, 87.5 ± 8.4, and 0.37 ± 0.29, respectively. In the present group, 24 cases were assessed as excellent healing, 12 cases were good, 7 cases were average, and 5 cases were poor. The percutaneous multi-angle thread needle was a reliable method for the treatment of two- or three-part displaced fractures of the proximal humerus in older people, especially for those who could not tolerate traumatic surgery.