OBJECTIVETo explore the clinical efficacy of self-made Kirschner wire hook in the treatment of severely displaced proximal humerus fractures in children.

METHODSFrom January 2007 to February 2012,35 children with severely displaced proximal humerus fractures were treated with self-made Kirschner wire hook fixation,including 25 boys and 10 girls with an average age of 13.2 years old ranging from 5 to 17. The duration from injury to operation was 1 to 10 days with an average of 4.5 days. Preoperative diagnoses were confirmed by X-ray films as type III in 26 cases and type IV in 9 according to the Neer-Horwitz classification of the proximal humerus fractures. All fractures were close fracture without nerve or vascular injuries. Anatomical reduction was achieved by open reduction and the fractures were fixed by self-made Kirschner wire hook. Intra-operative and postoperative complications, postoperative radiographic examination, upper extremity length and range of shoulder motion were observed and recorded. Neer score system was used to evaluate shoulder function.

RESULTSAll patients were followed up from 6 to 18 months with an average of 12.1 months. The mean Neer score of the injured side was 94.2 +/- 4.8 (ranged, 84 to 99), 30 patients got an excellent result and 5 good according to the Neer scores. The X-ray showed all the fractures healed without shortening deformity or epiphyseal arrest at early stage. There were no complications related to the implant including loosening or breakage of the self-made Kirschner wire hook. The range of shoulder motion in the injuried side was similar to the normal side, except in abductor lift. All the patients could participate in normal physical activities.

CONCLUSIONThe method of open reduction and fixed with self-made Kirschner wire hook is a safe,effective,convenient treatment for severely displaced proximal humeral fractures in children.