Clinical and Radiological Outcomes of Percutaneous Fixation of Proximal Humeral Fractures Neer’s Type 2 and 3 in Elderly by Wires

Background: Fractures involving the proximal humerus represent approximately 5–6% of all skeletal fractures, with their occurrence steadily increasing in the elderly population, largely as a consequence of low-energy falls sustained on osteoporotic bone. The optimal strategy for managing these injuries, remains a subject of considerable debate. Objectives: The present investigation comprehensively assessed both clinical and radiological outcomes following the use of closed reduction combined with percutaneous Kirschner-wire (K-wire) fixation in elderly individuals. Methods: This prospective clinical study enrolled 20 elderly patients presenting with low-energy Neer's type II or III proximal humeral fractures. Each participant underwent closed reduction and stabilization using 2.5 mm K-wires inserted percutaneously under fluoroscopic guidance. Functional outcomes were evaluated utilizing the Constant Score (CS), the Modified Constant Score (MCS), and the Visual Analogue Scale (VAS). Radiological assessment focused on fracture union, while postoperative complications were meticulously documented. Results: The mean operative time was 32.5±9.8 minutes. At the last follow-up. The MCS demonstrated excellent results in 5%, good in 55%, fair in 35%, and poor in 5%, with a mean ± SD of 62.5 ± 5.7. Radiographic union was achieved in all cases within 12 weeks. Complications included pin migration associated with infection in 30% of patients and pin migration with loss of reduction and malunion in 15%. Conclusion: Percutaneous K-wire fixation for Neer's type II and III proximal humeral fractures in the elderly constitutes a minimally invasive surgical option that provides satisfactory functional recovery, and a relatively low rate of major complications.