Publication:

Closed multiple intramedullary K-wire fixation for humeral shaft fractures in adolescents

Background Humeral shaft fractures are relatively uncommon injuries in aldolescents and can be managed conservatively in large number of patients. Management becomes easier as there is good potential for remodelling. Problem lies in displaced or unstable fractures, where satisfactory reduction and its maintenance are difficult. In smaller children this can even be managed by closed reduction and cast application. In adults and elderly patients early decision of open or closed reduction and internal fixation with plates and screws or intramedullary device respectively can be taken with some merits and demerits. We land up in dilemma when we have aldolescent patients to deal with.

Methods Forty adolescents patients with humeral shaft fractures were treated with closed multiple intramedullary K-wire fixations and were followed up. We included patients with displaced fractures, segmental fractures and humeral shaft fractures in polytrauma patients. Multiple intramedullary k-wire were used to stabilize the fracture after closed reduction under image intensifier.

Results This prospective study included 40 patients of humeral shaft fractures treated by closed K-wiring. All but 1 fracture united with a time span of 5-8 weeks with attainment of full range of movement at shoulder, elbow and wrist. Implant was removed after radiological union as a day care procedure under local anaesthesia, usually 6-8 weeks after surgery. There was 97.5% union rate.

Conclusions Closed intramedullary k-wire fixation is a minimally invasive procedure with excellent functional outcome.