20 to 30% of these fractures require surgical treatment according to the Neer criteria: fragments dislocation greater than 1 cm and/or an angle greater than 45°. A rigid fixation of proximal humeral fractures in elderly patients with osteoporotic bone is not satisfactory; new solutions are sought. The authors describe a minimally invasive technique that uses an intramedullary elastic implant – helix wire.
According to Neer’s classification: 18 two parts fractures, 12 three parts and 2 four parts. Osteosynthesis with cannulated screws was associated to the helix wire in three and four parts fractures. In all patients the shoulder was immobilized for 3 weeks. After 3 weeks patients started rehabilitation.
17 patients were assessed with mean follow-up of 18 months (4–52 months). The mean Constant score obtained was 66.2 points (53–90). 3 months after surgery all patients resumed their daily activities to the level before the fracture.
Our choice is based on the number of consolidations achieved through this technique and functional evaluation of these patients, which we consider satisfactory, taking into account that the functional requirements are lower than those of a young person. Intramedullary helical implant (helix wire) is simple and biological, suitable for elderly patients with poor bone, which enables percutaneous osteosynthesis using the techniques of indirect reduction and the association, when appropriate, of cannulated screws.