Surgical Treatment of Pediatric Proximal Humeral Fracture by Percutaneous Pinning

Abstract

Background: Proximal humeral fracture pattern varies based on the mechanism of injury and the patient’s age at the time of the injury. The purpose of this study was to prove short-term clinical and radiographic results of closed reduction and percutaneous pinning in displaced proximal humeral fractures in pediatric by K-wire. Subjects and Methods: This was clinical trial study included 18 children with proximal humeral fracture; their age ranged from 8 to 15 years with mean age 11.88 ± 2.08 with closed proximal humeral fracture between November 2019 and June 2020 at Zagazig University Hospital by closed reduction and percutaneous pinning under image intensifier using Kirschner-wires. Results: This study showed that 12 cases had no complication (66.7%), 3 cases had stiffness (16.7%), 2 cases had superficial infection (11.1%) and 1 case had loss of reduction (5.6%) and treated by K-wire removal, arm sling stabilizer. Two cases of superficial infection did not necessitate early removal of K-wires. All of them were treated with oral antibiotics. Conclusions: Additional K-wires through the lateral cortex give more stability for the severely displaced fractures with rotational or angular instability mainly type 4 fractures.