Transitory percutaneous pinning in fractures of the proximal humerus.

Abstract

We report 31 patients with displaced fractures of the proximal humerus treated by transitory percutaneous pinning. The Neer fracture classification was used; there were 7 two-part, 20 three-part, and 4 four-part fractures. The Constant score was used for evaluation of the results; the mean score was 80 points. The high mean age of our patients (68 years) diminished the score because of the 25 points attributed to the strength. Avascular necrosis was observed in 5 cases: 2 three-part and 3 four-part fractures. Transitory percutaneous pinning is a good technique for the management of displaced 3-part fractures of the proximal humerus even in the older population, keeping in mind that the shoulder will tolerate a moderate residual deformity without changing the functional outcome significantly. Transitory percutaneous pinning, on the other hand, is not a satisfactory method for the management of 4-part fractures.