Functional and radiological outcomes of percutaneous wiring for two and three part fractures of the proximal humerus.

Background: Proximal humerus fractures are common, with minimally displaced types often managed non-surgically. However, displaced fractures present a challenge due to complex patterns and numerous treatment options. While there is a general agreement on managing displaced four-part fractures in the elderly, two- and three-part fractures can be treated using various surgical methods, including open reduction and internal fixation (ORIF) with plate, ORIF with intramedullary nail, external fixation, screw fixation, arthroplasty, and percutaneous wiring. This study aims to evaluate the functional and radiological outcomes of treating two- and three-part proximal humerus fractures using closed percutaneous wire fixation. Methods: 39 patients, with a mean age of 67 years, treated with percutaneous wiring for displaced two and three-part proximal humerus fractures were prospectively evaluated. Radiological evaluation comprised of anteroposterior and axillary radiographs to look for union while functional evaluation was done using the Constant-Murley (CM) and American Shoulder and Elbow Society (ASES) scoring systems. Results: Union was seen in all the cases and 92.3 % patients had satisfactory result with a mean CM score of 72.7 and mean ASES score of 74.2, at an average follow up of 14 months (12-32 months). Three patients (7.69 %) had unsatisfactory results. One patient had malunion secondary to infection. Two patients had low functional scores secondary to systemic illnesses. None of the patients underwent revision surgery. Conclusion: Percutaneous wiring for displaced two- and three-part fractures of proximal humerus is a reliable, minimally invasive method of fixation. The procedure has predictable outcomes with low complication rate and can be performed under regional block. Level of Evidence: Level IV; Case series; Treatment Study.