title: Closed management and percutaneous fixation of unstable proximal humerus fractures.
abstract: BACKGROUND
  In dealing with displaced proximal humerus fractures, there is still much controversy in treatment modalities. The latest investigations emphasize the concept of minimal exposure and rigid fixation.
  
  
  METHODS
  The technique of closed reduction and percutaneous fixation with cannulated screws and k-pins was performed on 19 patients with two- and three-part proximal humerus fractures. The outcomes were evaluated with a mean follow-up of 21 months.
  
  
  RESULTS
  All except one case had a solid union of the fracture. Sixteen of 19 patients (84%) acquired good or excellent results according to Neer's classification. No further collapse or avascular necrosis was found.
  
  
  CONCLUSIONS
  The method of closed reduction and percutaneous fixation, although technically demanding, yields satisfactory results in displaced proximal humerus fracture. Cannulated screws provided rigid fixation that was the underlying tenet for early functional retrieval.
authors.affiliation: Department of Orthopaedic Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan, Republic of China.
authors.forename: C Y
authors.initials: CY
authors.lastname: Chen
authors.forename: E K
authors.initials: EK
authors.lastname: Chao
authors.forename: Y K
authors.initials: YK
authors.lastname: Tu
authors.forename: S W
authors.initials: SW
authors.lastname: Ueng
authors.forename: C H
authors.initials: CH
authors.lastname: Shih
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001858:Bone Nails; D001863:Bone Screws; D002648:Child; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome