Percutaneous reduction and external fixation for the treatment of 2-part surgical neck fractures of the proximal humerus
نویسندگان
1 Department of Trauma Orthopedics, Cangzhou Hospital of Integrated TCM-WM, Hebei, Cangzhou, 061000, China
2 Department of Trauma Orthopedics, Cangzhou Hospital of Integrated TCM-WM, Hebei, Cangzhou, 061000, China
3 Department of Trauma Orthopedics, Cangzhou Hospital of Integrated TCM-WM, Hebei, Cangzhou, 061000, China
4 Department of Surgery, Cangzhou Central Hospital, Cangzhou, 061000, China
5 Trauma Center, Third Hospital of Hebei Medical University, Shijiazhuang, 050000, China
6 Department of Trauma Orthopedics, Cangzhou Hospital of Integrated TCM-WM, Hebei, Cangzhou, 061000, China
7 Department of Orthopedics, First People's Hospital of Yuhang District, Hangzhou City, Zhejiang, 311100, China
doi
10.22034/ircmj.2023.189159چکیده
Background: Most proximal humerus fractures (4-5% of all systemic fractures) can be treated without surgery through early mobilization. However, the management of displaced fractures remains a subject of debate.Objectives: To evaluate the outcomes of closed reduction and percutaneous pinning for two-part surgical neck fractures of the proximal humerus.Methods: This was a retrospective analysis of 19 patients (8 men and 11 women with a mean age of 21.9 years) undergoing treatment in the Third Hospital of Hebei Medical University from January 2017 to December 2018 for surgical neck fractures of the proximal humerus. In 7 cases, the tails of Kirschner wires were linked with bone cement to prevent withdrawal after closed reduction and percutaneous pinning. The tails were attached to the unilateral external fixation in the other 12 patients to promote stability. A paired t-test was used to compare constant scores.Results: The mean constant score after operation was 82.4 at 3 months, 93.4 at 6 months, and 93.7 at 1 year. The score improved significantly from 3 to 6 months in both the bone cement and external fixation groups (P<0.05). The rate of K-wire loosening was lower with external fixation versus bone cement (8.3% vs 57.1%, P=0.038).Conclusion: The closed reduction and percutaneous pinning method showed good outcomes for two-part surgical neck fractures. External fixation provides better stability compared to cement fixation alone. This minimally invasive approach is an alternative to open reduction in selected patients.
