Objective: The closed reduction and fixation by percutaneous pinning is a simple method for treatment of the proximal humeral fractures. Especially in the comminuted fractures, mini-open reduction may be a raising factor for the treatment success. The aim of this study, was to evaluate of clinical effectiveness of pinning and fixation methods using mini-open reduction and closed reduction in the surgical treatment of proximal humeral fractures.
Methods: The clinical outcomes of 26 patients with comminuted proximal humeral fractures treated surgically (Group 1: 13 cases, closed reduction, pinning and fixation and Group 2: 13 cases mini-open reduction, pinnig and fixation) were evaluated retrospectively. Both groups were consisted of 7 Neer type 3 and 6 Neer type 4 proximal humeral fracture cases. The Constan scores, range of motion and complicationsof the two groups were compared statistically.
Results: Mean Constant scores were 38.2 (24-61) and 47.3 (17,5-64) in group 1 and in group 2, respectively. (p:0,166). In group 1 the mean anterior flexion was 83° (60°-120°) and abduction was 80°(60°-120°). In group 2 anterior flexion and abduction were 90°(60°-150°) and 85.4° (60°-150°), respectively (p:0,585, p:0,638). One psodoarthrosis, one avascular necrosis and two malunion were seen in group 1, while in group 2, one glenohumeral joint arthrosis and one pin migration were seen. No neuro-vascular injury or infection was seen.
Conclusions: In the surgical treatment of comminuted proximal humeral fractures, using mini-open or closed reduction and pinning methods, similar clinical results may be obtained, but it seems quite difficult to be succesfull by both methods especially in the comminuted fractures.
Key words: Proximal humeral fracture, percutaneous pinning, closed reduction, mini-open reduction
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