Multifragmentary proximal humerus fracture successfully treated with k-wire fixation: A case report

The ideal treatment of proximal humerus fracture remains a controversial topic, especially in the case of complex multi-fragmentary fractures. However, in limited resource settings, alternative less complicated fixation may be considered in highly selected patients without compromising the functional outcome. We report a case of successful treatment with k-wire fixation with satisfactory functional outcome.

A 22-year-old female presenting with a right-sided closed multi-fragmentary proximal humerus fracture following a motor vehicle collision. A complex multi-fragmentary right-sided proximal humerus fracture (AO 11C3, Codman-Hertel type 12) was diagnosed based on the shoulder x-ray and computed tomography 3-dimensional reconstruction. She underwent an open reduction and k-wire fixation under image guidance. She had satisfactory functional outcome 6 months after surgery with painless near-total range of motion.

The ongoing debate of the optimal surgical management for complex proximal humerus fractures implies that the best treatment should be made on an individual basis. The probable reason for the good outcome in our patient may be the combination of intact blood supply and periosteum, intact rotator cuff mechanism, young patient with healthy bone metabolism and achievement of good reduction with restoration of the articular surface and calcar.

Although this successful case of k-wire fixation is not sufficient to challenge the option of primary arthroplasty, this low cost, readily, available simple strategy may be useful in highly selective instances.