Proximal Humerus Fractures: Closed Reduction and Pinning/ Percutaneous K wire Fixation скачать в хорошем качестве

Proximal Humerus Fractures: Closed Reduction and Pinning/ Percutaneous K wire Fixation

Fluoroscopy in proximal humerus fractures simplified    • Fluoroscopy in proximal humerus fractures ...   K-wire (Kirschner wire) fixation/Pinning is a minimally invasive technique often used in the treatment of proximal humerus fractures, particularly in pediatric patients, elderly individuals with osteoporotic bone, or selected low-energy two-part fractures. Indications: Minimally displaced or reducible 2-part surgical neck fractures Pediatric proximal humerus fractures Elderly patients with poor bone quality where other fixation may be contraindicated Temporary fixation in complex fracture patterns (as adjunct to plating) Advantages: Minimally invasive and cost-effective Preserves soft tissue and blood supply Short operative time Useful in resource-limited settings Easily removable in outpatient setting Technique Highlights: Achieve closed or percutaneous reduction under fluoroscopy Insert 2–3 parallel or crossed K-wires from lateral or anterolateral approach Ensure adequate fixation across fracture site and avoid intra-articular penetration Confirm position under C-arm and bend external ends to prevent migration Post-operative Care: Immobilization in a sling or shoulder immobilizer Regular radiographs to monitor fracture union and K-wire position Early passive motion as tolerated K-wire removal at 4–6 weeks once callus formation is evident Limitations: Risk of pin migration and infection Limited stability in multi-fragmentary fractures Not suitable for osteoporotic bone in all cases Risk of neurovascular injury if improperly placed Summary: K-wire fixation remains a valuable technique for selected proximal humerus fractures, especially where simplicity, cost, and minimal invasiveness are prioritized. Careful patient selection and meticulous technique are critical for good outcomes.