COMPARATIVE STUDY BETWEEN TRADITIONAL PERCUTANEOUS PINNING AND AUGMENTED BY EXTERNAL FIXATOR FOR MANAGEMENT OF UNSTABLE PROXIMAL HUMERAL FRACTURES

*Mohamed Abdel Aziz Hassan

ABSTRACT

Background: Fracture of the proximal humerus is a common and debilitating injury occurring mainly in elderly and osteoporotic people and accounts for 4‑5% of all adult fractures. Many treatment options are available like conservative treatment, internal fixation, joint replacement and percutaneous fixation. Objective: This is a comparative study between traditional percutaeneus pinning (TPP) and minimally invasive reduction and osteosynthesis system (MIROS) for management of proximal humeral fractures in elderly patients with high operative risk factors. Patients and methods: this prospective study was conducted on 20 patients (n=20) having proximal humeral fractures treated by closed reduction and traditional percutaneous pinning (TPP) in one group (A) versus percutaneous pinning augmented by external fixator (MIROS) in second group (B). Results: Average constant score was 76.45 (range 55- 90) and 88.54 (range 84-95) in groups (A) and (B) respectively. On comparison of these two groups with T- test there is a significant difference with p<0.005 suggestive of significant good results in (B) group. Conclusion: Percutaneous pinning is a good treatment option in high operative risk patients and adding an external fixation to that helps in maintaining valgus of the head, preventing pin migration, pin back out, pin loosening and minimizes the complications of percutaneous pinning alone even in osteoporotic patients.

Keywords: proximal humeral fractures, traditional percutaneous pinning, MIROS.