To introduce a surgical technique of retrograde pin fixation with tension band wiring for the proximal humeral fractures and to evaluate the clinical results.

The clinical results of thirty-two patients who underwent surgical treatment for the proximal humeral fractures, during the period from June 1996 to June 2001, using a retrograde pin fixation with tension band wiring were reviewed. The mean followup was 2.5 years (1-5 years) Twelve patients had a two-part fracture, and twenty patients had a three-part fracture with Neer's classification. We analyzed the clinical results using Neer score and radiological state using Zyto's three-point graded scale.

By clinical evaluation, eighteen cases (56%) were excellent, twelve cases (38%) were satisfactory, one case (3%) was unsatisfactory and one case (3%) was failure. By radiological evaluation, twenty-one cases (66%) were good, nine cases (28%) were acceptable and two cases (6%) were poor. Three unsatisfactory cases were a case with pin migration, loss of reduction or avascular necrosis. There was not a case of delayed union, nonunion or infection.

Retrograde pin fixation with tension band wiring for the proximal humeral fractures was considered to be a useful method, which is easy and induces limited soft tissue injury, and provides enough stability for postoperative rehabilitation in majority cases such as surgical neck or three-part fractures.