Percutaneous fixation of unstable proximal humeral fractures augmented with external Ilizarov cubes: a new simple technique

Abstract

Purpose
To present the management of unstable proximal humeral fractures with percutaneous pinning augmented by an external Ilizarov cubes in elderly patients with poor general condition.


Patients and methods
Between October 2021 and December 2021, 7 patients (mean age: 56.7, range 53–62) with three-part proximal humeral fracture with 2 or more co-morbidities were surgically managed by percutaneous pinning augmented by an external cube. Functional results were evaluated through measuring shoulder range of motion. Radiological evaluation was done by antero-posterior and lateral radiograms of the treated humerus.


Results
The patients were followed up for an average period of 6 months. The external cube and the pins were removed at about the 6 weeks mark. The average range of motion at the final follow up was Abduction 110°, forward flexion 140°, internal rotation 60°, external rotation 58°.
All patients achieved full radiological union.


Conclusion
Percutaneous fixation of unstable humeral fractures is an effective method of treatment especially in elderly patients with multiple co-morbidities. Adding external Ilizarov cubes to the construct is an easy, affordable, and quick method of improving results and minimizing complications of early pin loosening that give the ability of early range of motion and rapid bone union.