Publication:

The study of functional outcome of k-wire fixation with link joints in proximal humerus fractures

Background Proximal humeral fractures are the common type of osteoporotic fractures seen in elderly patients. The objective was to evaluate the functional outcome of a novel modification of percutaneous k-wire fixation technique using Neer’s classification. In this technique, the transfixing K wires were linked together with a link joint which functions as an external fixator, easily available and cheap compared to MIROS (Minimally invasive reduction and osteosyntesis system) and also has additional advantage of trans fixation.

Methods The prospective study was conducted in MBS and new medical college, Kota, India over a 24 months period, we treated 25 patients of minimally displaced two-, three- and four-part fractures, 14 patients (56%) were males and 11 patients (44%) were females. Mean age of the patients were 50.52±14.46 years, the mean surgical time was 30.4 min. mean fluoroscopy time was 42.64 seconds, all k wire and link joints removed at 9.5 weeks. mean clinical union was 7.94 weeks.

Results Final constant score at 18 months was 80.28±4.09. Mean abduction was 129.6±30.6 degrees, the mean anterior forward flexion was 125.5±25degrees. 2 patients developed pin tract infection, 1 patient developed stiffness .4 patients (16%) had fair results, 18 patients (72%) had good results and 3 patients (12%) had excellent results.

Conclusions The modified novel method that takes advantage of the minimal invasive approach for treating proximal humeral fractures by Kirschner wire mutual linking technique with link joints, providing a great deal of flexibility in the fixation construct's composition which is cost effective and provide even more stability.