Fluoroscopic guided close reduction and percutaneous k-wire fixation of paediatric proximal humeral fractures

Background: Paediatric proximal humeral fractures, relatively rare injuries are often managed conservatively. In adolescent patients owing to less remodelling potential of fracture site with residual gross angulation and deformity, surgical reduction and fixation is increasingly advocated. However, controversy continues regarding ideal fixation techniques of these fractures. With the ease of application and preventable minor complications, closed reduction and percutaneous k-wire fixation is probably the better option available.

Materials and methods: This was a prospective study in tertiary hospital from 2013 to 2015 comprising of 18 patients treated by closed reduction and percutaneous k-wire fixation under fluoroscopic guidance. Most common cause of fracture was fall from height and male patients predominated the study. Most of the cases were Salter- Harris type II and Neer Horowitz type IV injuries.

Results: With a mean follow-up of 1.8 years, average healing was observed at 6 weeks. Eighty percent of cases were excellent and none as poor. Four patients developed superficial pin tract infection and none deep infection. There was no case of postoperative neurovascular deficit.

Conclusion: Closed reduction under fluoroscopic guidance with percutaneous k-wire fixation is safe, effective, reliable, reproducible and economical method of proximal humeral fractures