Minimally invasive deltoid-splitting approach for treatment of proximal humeral fractures: a case-control study

Abstract

Objective To evaluate the clinical outcomes of minimally invasive percutaneous locking plate osteosynthesis (MIPPO) via deltoid-splitting approach in the treatment of proximal humeral fractures.Methods From June 2010 to December 2012,60 cases of proximal humeral fractures were treated in our hospital with locking plate osteosynthesis.Among them,27 cases were treated with minimally invasive percutaneous plate osteosynthesis (MIPPO) via the anterolateral dehoid-splitting approach (group DS),while 33 cases were treated with open reduction and internal fixation through a traditional deltopectoral approach (group DP).Operation time,blood loss,wound complications and hospital stay time were compared between these two groups.Postoperative shoulder functions were assessed using Constant scores.Results Patients were follow-up for 12 to 24 months (average,18.6 months).There was no difference in the operation time between the two groups (P ＞ 0.05).Blood loss was lower in the DS group than in the DP group (P ＜ 0.05).The DS group had a significantly shorter hospital stay than the DP group (P ＜ 0.05).The difference of the mean healing time between two groups was not significant.The mean Constant score after 3 months showed higher values for group DS versus group DP.However at 6 and 12 months follow-up the scores of two groups had no statistically significant difference.The rate of complications of the DS group was lower than that of the DP group (P ＜ 0.05).Conclusion Pereutaneous locking plate osteosynthesis via deltoid-splitting approach has the advantages of less blood loss,less vascular damage,lower risk of complications and rapid recovery.It is an effective treatment for proximal humeral fractures. Key words: Humeral fractures, proximal; Surgical procedures, minimally invasive; Case-control studies