Percutaneous Pinning for Surgical Neck Fracture: Method of Choice—Affirms

Percutaneous pinning for proximal humerus fractures is an excellent treatment method in appropriate selected patients. Indications include low energy injuries, valgus impacted proximal humerus fractures, fractures with good bone stock, no medial calcar comminution, and minimal tuberosity comminution. Contraindications include high energy injuries, fractures with comminution at the medial calcar and tuberosities, osteopenia, and unreliable patients. Advantages over open reduction and internal fixation include shorter operating room time, less soft tissue stripping around the fracture, smaller incision and less scarring. While there is a steep learning curve, percutaneous pinning has distinct advantages in selected cases, making it a useful part of the armamentarium for treatment of proximal humerus fractures.