Technical Trick

Technique of Kirschner Wire Reduction and Fixation of Displaced Two-Part Valgus Angulated Proximal Humerus Fractures at the Surgical Neck

Seyhan, Mustafa MD^*; Kocaoglu, Baris MD^†; Nalbantoglu, Ufuk MD^†; Aydin, Nuri MD^‡; Guven, Osman MD^*

^*Acibadem Kadikoy Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey

^†Acibadem University Faculty of Medicine, Department of Orthopaedics and Traumatology, Istanbul, Turkey

^‡Uskudar Government Hospital, Department of Orthopaedics and Traumatology, Istanbul, Turkey.

No funds were received in support of this work.

No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Reprints: Baris Kocaoglu, MD, Acibadem University Faculty of Medicine, Department of Orthopaedics and Traumatology, Barbaros mah. Kentplus 1. Etap, C1 blok D:52 Yenisahra, Istanbul, Turkey (e-mail: [email protected]).

Accepted May 19, 2011

Journal of Orthopaedic Trauma 26(6):p e46-e50, June 2012. | DOI: 10.1097/BOT.0b013e3182254ecc

Abstract

Summary:

This article describes the technique of closed reduction with percutaneous fixation using Kirschner wires in helping the reduction of two-part valgus angulated and displaced proximal humerus fractures at the surgical neck. Traditional open reduction may lead to more accurate anatomic reduction; however, extensive tissue dissection increases the risk of avascular necrosis. Thus, closed reduction of unstable fracture mostly required forceful reduction maneuvers, which can harm the vascular supply and increase hematoma formation. Reduction of the fractured sides can easily be performed by engaging Kirschner -wires with a joystick method and fixation can be secured by using threaded pins. Thirty-six consecutive patients with displaced, two-part, valgus-angulated proximal humerus fractures at the surgical neck were treated by this method. The patients were followed for an average of 38 months. All fractures healed. According to the Constant scoring system, 21 patients (58%) had excellent, 9 patients (25%) had good, and 6 patients (17%) had fair results. The technique of closed reduction with a joystick method and percutaneous fixation is regarded as a reasonable treatment alternative in displaced two-part valgus angulated proximal humerus fracture.