Modified lateral approach versus deltopectoral approach in treatment of elderly proximal humeral fractures

Abstract

Objective To compare the clinical effects of proximal humerus locking compression plate (PHILOS) through the modified lateral approach and deltopectoral approach in the treatment of senile proximal humeral fractures. Methods From May 2012 to February 2015, 40 patients with fresh senile proximal humeral fractures were treated in our department. There were 18 males and 22 females. According to the surgical approach they were divided into 2 groups: conventional group (the deltopectoral approach) of 20 patients and minimally invasive group (the modified lateral approach) of 20 patients. They were treated by PHILOS fixation. The intraoperative blood loss, operation time, intraoperative and postoperative complications, Constant scores at 1 month, 3 months and the last follow-up, as well as X-ray films of the affected shoulder at follow-up, were analyzed and compared between the 2 groups. Results All the 40 cases were follow-up for an average of 16 months (range, 7 to 33 months). No incision infection occurred and bony union was all achieved. The minimally invasive group were significantly better than the conventional group in blood loss, operation time, incision length and union time (P 0.05). In the conventional group, cephalic vein injury occurred in 2 cases. Conclusion The modified lateral approach applied in the treatment of proximal humeral fractures has the advantages of less trauma and quicker recovery, which provides a good alternative for senile proximal humeral fractures. Key words: Shoulder joint; Fracture fixation,internal; Surgical procedures,minimally invasive; Approach