Effect of deltoid approach combined with locking plate internal fixation on the degree of postoperative pain and shoulder function in patients with proximal humeral fracture

Abstract

Objective To investigate the effect of deltoid approach combined with locking plate internal fixation on the degree of postoperative pain and shoulder function in patients with proximal humeral fracture. Methods A total of 137 cases of proximal humeral fractures in our hospital from January 2015 to February 2017 were selected and were divided into two groups according to different treatment methods. The control group (n=68) was treated with deltoid muscle pectoralis major approach combined with locking plate internal fixation, while the study group (n=69) was treated with deltoid approach combined with locking plate internal fixation. The status of the operation and postoperative recovery, pain degree (VAS), shoulder function (Neer), quality of life (WHOQOL-100) score, fracture healing time, and complications were analyzed and compared between the 2 groups. Results The incision length of the study group [(7.13±0.78)cm] was less than that of the control group, and the operation time [(53.69±8.61)min], intraoperative blood loss [(156.41±20.68)ml], postoperative drainage volume [(86.53±9.81)ml], hospitalization time [(6.84±1.16)d] were less than those of the control group (P<0.05). At the end of the follow-up, the VAS score of the study group was lower than that of the control group [(1.59±0.24)points vs.(2.14±0.89)points], and the scores of Neer, WHOQOL-100 were higher than those of the control group [(92.31±12.67)points vs.(81.27±8.02)points; (93.61±9.48)points vs.(81.27±8.02)points] (P<0.05). The fracture healing time in the study group was shorter than that in the control group [(9.43±1.58) weeks vs.(11.21±2.43) weeks; t=5.090, P=0.000]. The total complication rate in the study group was 1.45% (1/69), lower than that in the control group [14.71% (10/68)] (P<0.05). Conclusion Deltoid approach combined with locking plate internal fixation is effective in the treatment of proximal humeral fractures, which can effectively shorten the healing time of fracture, reduce pain, improve shoulder function, and improve the quality of life. Key words: Deltoid approach; Locking plate internal fixation; Proximal humeral fractures; Postoperative pain degree; Shoulder function