Functional Outcomes of Percutaneous K-Wire Fixation in Proximal Humerus Fractures in the Elderly: A Focused Systematic Review of 10 studies

Abstract Background Proximal humerus fractures are more common in the elderly, especially due to osteoporosis and low-energy falls. Treatment options range from conservative management to complex surgical fixation. Percutaneous K-wire fixation offers a minimally invasive and cost-effective alternative treatment. Objective This focused systematic review aims to evaluate the functional outcomes, complication rates, and union time following percutaneous K-wire fixation in elderly patients with proximal humerus fractures. Methods A focused systematic review evaluated 10 key studies published between 2010 and 2024. Literature was identified through PubMed, Google Scholar, and manual reference mining. Studies included elderly patients (≥ 60 years) treated with percutaneous K-wire fixation, reporting functional outcomes such as Constant-Murley or DASH scores. Results This focused review synthesized evidence from 10 studies. Across these, percutaneous K-wire fixation yielded good to excellent functional outcomes in elderly patients, especially in two- and three-part Neer fractures. Union occurred in 8–12 weeks in most cases. Complications included pin migration (up to 7%), superficial infections, and rare osteonecrosis. Functional outcome scores ranged from 70 to 90 (Constant score) in most studies. Conclusion Percutaneous K-wire fixation is a valuable treatment option for proximal humerus fractures in elderly patients, particularly in low-resource settings. When appropriately selected, patients can achieve satisfactory function with minimal complications.