Humeral Shaft Fractures Treated by Closed Retrograde Intramedullary Kirschner Wire Fixation


Department of Orthopaedics, Mahatma Gandhi Institute of Medical Sciences, Wardha, Maharashtra, India


Context: Flexible intramedullary nails have been reported to provide a stable humeral fixation with satisfactory results in terms of union and complications. In this study, Kirschner wire (K‑wire) was used to achieve a closed intramedullary fixation of humeral shaft fractures.
Subjects and Methods: This study included forty cases of the displaced diaphyseal fracture of the humerus based on inclusion and exclusion criteria. The study was done at Kasturba Hospital, Mahatma Gandhi Institute of Medical Sciences (MGIMS), Sevagram, between the periods January 2003 and November 2006. All the cases were operated after clinical evaluation. The final evaluation of the result was done by Qidwai’s clinical and radiological criteria. Results: A total of forty cases were available for the study. K‑wire of different sizes was used; the average duration of surgery was 45.3 ± 7.2 min. The average time taken for radiological union was 12.1 ± 1.9 weeks. The patients were analyzed by Qidwai’s criteria and had excellent result in 30 (83.3%) cases, good in 4 (11.1%) cases, and poor in 2 (5.6%) cases. Three patients were lost to follow‑up, and one patient was died due to medical illness. Conclusion: Intramedullary K‑wire fixation is a satisfactory, safe, simple,
minimally invasive technique and cost‑effective treatment for humeral shaft fractures. It gives elastic mobility and stability.


1. Huttunen TT, Kannus P, Lepola V, Pihlajamäki H, Mattila VM. Surgical treatment of humeral‑shaft fractures: A register‑based study in Finland between 1987 and 2009. Injury 2012;43:1704‑8. 
2. Tytherleigh‑Strong G, Walls N, McQueen MM. The epidemiology of humeral shaft fractures. J Bone Joint Surg Br 1998;80:249‑53. 
3. Garnavos C. Diaphyseal humeral fractures and intramedullary nailing: Can we improve outcomes? Indian J Orthop 2011;45:208‑15. 
4. Qidwai SA. Treatment of humeral shaft fractures by closed fixation using multiple intramedullary Kirschner wires. J Trauma 2000;49:81‑5. 
5. Rommens PM, Verbruggen J, Broos PL. Retrograde locked nailing of humeral shaft fractures. A review of 39 patients. J Bone Joint Surg Br 1995;77:84‑9. 
6. Stern PJ, Mattingly DA, Pomeroy DL, Zenni EJ Jr, Kreig JK. Intramedullary fixation of humeral shaft fractures. J Bone Joint Surg Am 1984;66:639‑46. 
7. Bell MJ, Beauchamp CG, Kellam JK, McMurtry RY. The results of plating humeral shaft fractures in patients with multiple injuries. The Sunnybrook experience. J Bone Joint Surg Br 1985;67:293‑6. 
8. Hall RF Jr, Pankovich AM. Ender nailing of acute fractures of the humerus. A study of closed fixation by intramedullary nails without reaming. J Bone Joint Surg Am 1987;69:558‑67. 
9. Brumback RJ, Bosse MJ, Poka A, Burgess AR. Intramedullary stabilization of humeral shaft fractures in patients with multiple trauma. J Bone Joint Surg Am 1986;68:960‑70. 
10. Weseley MS, Barenfeld PA, Eisenstein AL. Rush pin intramedullary fixation for fractures of the proximal humerus. J Trauma 1977;17:29‑37.