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

Abstract

    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.