Modified Minimally Invasive Reduction and Osteosynthesis System Technique for Fixation of Proximal Humeral Fractures versus Multiple K-Wires Fixation

Background: Fractures of the upper extremity, most commonly the proximal humerus, are commonly treated with the Minimally Invasive Reduction and Osteosynthesis System (MIROS) as well as a modified version of it.
Objective: To compare the radiological and functional outcome of modified MIROS technique and traditional multiple K-wires fixation for the treatment of proximal humeral fractures.
Patients and Methods: At Orthopedic Department of Zagazig University Hospital, we operated upon 18 patients, with a mean age of 53.1 ±9.79, 6 patients had two-part, 7 patients had three-part and 5 patients had four-part fractures, half of them were treated by K-wires and the other by Modified MIROS technique.
Results: The mean Constant score (CS) for the entire series, at the end of the follow-up period, was 74.5±17.40 in the K-wires group, 2 patients had excellent results, 3 patients had good results, 2 patients had fair results and 2 patients had poor results. In the Modified MIROS group, the mean CS was 81.5± 17.62, 3 patients had excellent results, 3 patients had good results, 2 patients had fair results and 1 patient had poor results. 7 patients had complication, 4 patients in the K-wires group as pin tract infection, delayed union, stiffness and nonunion, 3 patients in the modified MIROS group as pin tract infection, shoulder stiffness and inferior subluxation of glenohumeral joint.
Conclusion: Modified MIROS technique can be a very demanding procedure that may fail to provide a satisfactory reduction, particularly in dislocation with four-part injuries.