[Traditional manipulative reduction and percutaneous elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children].

OBJECTIVE: To study clinical effects and safety of traditional manipulative reduction and percutaneous elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children.

METHODS: From October 2012 to May 2016, 65 patients with proximal humeral fractures were treated with traditional manipulative reduction and percutaneous elastic intramedullary nail fixation. There were 52 boys and 13 girls, ranging in age from 7 to 14 years old, with an average age of 11.2 years old. Twenty-three patients had injuries on the left side, and 42 patients had injuries on the right side. There were 13 cases of oblique fracture, 49 cases of transverse fracture, and 3 cases of comminuted fracture. All the patients had closed, obviously displaced fractures, without vascular and nerve injuries. The duration from injury to treatment ranged from 20 minutes to 5 days, with a mean of 3 days. The fracture healing and complications were observed after operation, and the curative effect was evaluated by Neer shoulder function score.

RESULTS: The operation time ranged from 30 to 40 minutes, with a mean of 35 minutes; intraoperative blood loss ranged from 5 to 10 ml, with a mean of 6.5 ml. All the patients were followed up, and the duration ranged from 12 to 28 months, with an average of 18 months. All the fractures healed. According to the Neer evaluation system, 59 patients got an excellent result, 5 good and 1 fair. Four patients had a small amount of secretions on the tail of the needle; 2 patients had skin irritation; 1 patient had partial withdrawal of the nail, and the skin in all the patients healed after taking out the nail. No patients had nonunion fractures due to the broken nails and loosen screws, and no vascular or nerve injuries occurred.

CONCLUSIONS: Traditional manipulative reduction and percutaneous elastic intramedullary nail fixation for the treatment of proximal humeral fractures in children has the advantages of less trauma, quicker recovery, less complications and simple operation.