Which patient would NOT be a good candidate for percutaneous pinning of a proximal humeral fracture?

The correct answer identifies a patient with a high likelihood for Avascular Necrosis (AVN) as not being a good candidate for percutaneous pinning of a proximal humeral fracture. This is important because the risk of AVN significantly impacts the healing and functional outcomes of the injury.

In cases of high likelihood for AVN, especially in proximal humeral fractures, the blood supply to the humeral head can be compromised. This makes surgical interventions that do not adequately stabilize the fracture or restore the vascular supply to the area distinctly less favorable, as these patients are at greater risk for complications including nonunion and osteonecrosis. Percutaneous pinning, while less invasive, may not provide the necessary stability and blood flow restoration that more complex surgical interventions might offer in these situations.

In contrast, patients with a 2-part or 3-part fracture may still be suitable candidates for percutaneous pinning if the fractures are well-aligned and the overall stability is manageable without significant risk factors for AVN. If these patients are assessed to have a low likelihood for AVN, the procedure can be performed with a higher confidence in successful healing and restoration of function. Thus, the selection of candidates for percutaneous pinning must carefully consider their specific risk