27Feb 2017

PERCUTANEOUS K-WIRE FIXATION FOR A COMMINUTED PROXIMAL HUMERUS FRACTURE – A CASE REPORT.

  • Department of Orthopaedics, Professor and Head of the Department, Deccan College of Medical Sciences.
  • Department of Orthopaedics, Senior-Resident, Deccan College of Medical Sciences.
  • Department of Orthopaedics, Post-Graduate, Deccan College of Medical Sciences.
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Severe proximal Humerus fractures when left untreated have a poor functional outcome because of severe displacement of the fragments. Reduction is essential even though there is a danger that Open Reduction and Internal Fixation may increase the risk of avascular necrosis, especially in 4-part fractures. Open reduction doubles the risk of avascular necrosis compared with closed treatment [1]. The risk is increased still further by the exposure required for plating compared with that for a lesser procedure [2,3,4]. Here we describe a case of 90-year-old elderly female presenting with pain and restricted range of right shoulder movements following fall at her residence and was incidentally found to be suffering with severe anemia which was managed with a minimally invasive technique.

  1. H¨agg O, Lundberg BJ. Aspects of prognostic factors in comminuted and dislocated proximal humerus fractures. In: Bateman JE, Welsh RP, eds. Surgery of the shoulder. Philadelphia, Decker, 1984.
  2. Jaberg H, Jakob RP. Tr¨ummerfrakturen des proximalen Humerus. Orthop¨adie 1987;16:320-35.
  3. Jakob RP, Ganz R. Proximale humerusfrakturen. Helv Chir Acta 1981;48:595-610.
  4. M¨unst P, Kuner EH. Osteosynthesis in dislocated fractures of the humerus head. Orthop¨ade 1992;21:121-30.
  5. Gerber C,Warner JJP: Alternatives to hemiarthroplasty for complex proximal humeral fractures, in Warner JJP, Iannotti JP, Gerber C (eds): Complex and Revision Problems in Shoulder Surgery. Philadelphia, PA, Lippincott, Williams & Wilkins, 1997, pp 215-243.
  6. Bohler J: Les fractures recentes de l’epaule. Acta Orthop Belg 1964;30:235.
  7. Jaberg H,Warner JJ, Jakob RP: Percutaneous stabilization of unstable fractures of the humerus. J Bone Joint Surg Am 1992;74:508-515.
  8. Resch H, Povacz P, Frohlich R,Wambacher M: Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br 1997;79:295- 300.
  9. Herscovici D Jr, Saunders DT, Johnson MP, Sanders R, DiPasquale T: Percutaneous fixation of proximal humeral fractures. Clin Orthop 2000;375:97 104.
  10. Resch H, Hubner C, Schwaiger R: Minimally invasive reduction and osteosynthesis of articular fractures of the humeral head. Injury 2001;32(suppl 1):SA25-SA32.
  11. Gerber C, Schneeberger AG, Vinh TS: The arterial vascularization of the humeral head: An anatomical study. J Bone Joint Surg Am 1990;72:1486-1494.
  12. Chen CY, Chao EK, Tu YK, Ueng SW, Shih CH: Closed management and percutaneous fixation of unstable proximal humerus fractures. J Trauma 1998;45:1039-1045.
  13. Ebraheim N,Wong FY, Biyani A: Percutaneous pinning of the proximal humerus. Am J Orthop 1996;25:500-506.
  14. Kocialkowski A,Wallace WA: Closed percutaneous Kwire stabilization for displaced fractures of the surgical neck of the humerus. Injury 1990;21:209-212.
  15. Soete PJ, Clayson PE, Costenoble VH: Transitory percutaneous pinning in fractures of the proximal humerus. J Shoulder Elbow Surg 1999;8:569-573.
  16. Williams GR Jr,Wong KL: Two-part and three-part fractures: Open reduction and internal fixation versus closed reduction and percutaneous pinning. Orthop Clin North Am 2000; 31:1-21.
  17. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand 2001;72:365-71.
  18. Court-Brown CM, Caesar B. Epidemiology of adult fractures: a review. Injury 2006;37:691-7.
  19. Helmy N, Hintermann B. New trends in the treatment of proximal humerus fractures. Clin Orthop 2006;442:100-8
  20. Neer CS. Four segment classification of displaced proximal humeral fractures AAOS Instructional Course Lecture 1975;24:160–168.

[Mazharuddin Ali Khan, Chinnala Srujan Kumar, Sarosh Haidry and P. Akbar Basha. (2017); PERCUTANEOUS K-WIRE FIXATION FOR A COMMINUTED PROXIMAL HUMERUS FRACTURE – A CASE REPORT. Int. J. of Adv. Res. 5 (Feb). 1522-1525] (ISSN 2320-5407). www.journalijar.com

Dr.Chinnala Srujan Kumar
Deccan College of Medical Sciences

DOI:

Article DOI: 10.21474/IJAR01/3309      
DOI URL: https://dx.doi.org/10.21474/IJAR01/3309

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