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Comparison between minimally invasive deltoid-split and extended deltoid-split approach for proximal humeral fractures: a case-control study.
Wang, Ji-Qi; Lin, Chui-Cong; Zhao, You-Ming; Jiang, Bing-Jie; Huang, Xiao-Jing.
Affiliation
  • Wang JQ; Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, 325000, Zhejiang, China.
  • Lin CC; Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village Ouhai District, Wenzhou, 325000, Zhejiang, China.
  • Zhao YM; Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, 325000, Zhejiang, China.
  • Jiang BJ; Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, 109# Xue Yuan Xi Road, Wenzhou, 325000, Zhejiang, China.
  • Huang XJ; Department of Orthopaedics, The First Affiliated Hospital of Wenzhou Medical University, Shangcai Village Ouhai District, Wenzhou, 325000, Zhejiang, China. wzhuangxiaojing@hotmail.com.
BMC Musculoskelet Disord ; 21(1): 406, 2020 Jun 27.
Article in En | MEDLINE | ID: mdl-32593311
BACKGROUND: With the rapid aging of the population, the incidence of proximal humeral fracture (PHF) has increased. However, the optimal method for open reduction and internal fixation (ORIF) remains controversial. METHODS: We performed a retrospective analysis of patients with PHF who underwent locking plate internal fixation at our institution from January 2016 to December 2018. Patients were divided into two groups based on the surgical approach used: an expanded deltoid-split approach group (ORIF group) and minimally invasive deltoid-split approach group (minimally invasive percutaneous plate osteosynthesis, [MIPPO] group). The groups were compared in terms of demographic and perioperative characteristics, and clinical outcomes. RESULTS: A total of 115 cases of PHF were included in our study, of which 64 cases were treated using the minimally invasive deltoid-split approach and 51 using the extended deltoid-split approach. Fluoroscopy was performed significantly less frequently in the ORIF group and the surgical duration was shorter. However, the postoperative visual analogue scale (VAS) pain score and duration of postoperative hospital stay were significantly higher compared to the MIPPO group. Moreover, secondary loss was significantly less extensive in the ORIF group compared to the MIPPO group, while there was no significant group difference in fracture healing time, Constant shoulder score, or complications at the last follow-up visit. CONCLUSIONS: The clinical outcomes associated with both the minimally invasive and extended deltoid-split approaches were satisfactory. The data presented here suggest that the extended deltoid-split approach was superior to the minimally invasive deltoid-split approach in terms of operational time, fluoroscopy, and secondary loss of reduction, while the minimally invasive approach was superior in terms of postoperative pain and hospital stay. Accordingly, neither procedure can be considered definitively superior; the optimal surgical procedure for PHF can only be determined after full consideration of the situation and requirements of the individual patient.
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Full text: 1 Collection: 01-internacional Topics: Promover_ampliacao_atencao_especializada Database: MEDLINE Main subject: Shoulder Fractures / Bone Plates / Minimally Invasive Surgical Procedures / Deltoid Muscle / Fracture Fixation, Internal Type of study: Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: BMC Musculoskelet Disord Year: 2020 Document type: Article

Full text: 1 Collection: 01-internacional Topics: Promover_ampliacao_atencao_especializada Database: MEDLINE Main subject: Shoulder Fractures / Bone Plates / Minimally Invasive Surgical Procedures / Deltoid Muscle / Fracture Fixation, Internal Type of study: Observational_studies / Risk_factors_studies Limits: Aged / Female / Humans / Male / Middle aged Language: En Journal: BMC Musculoskelet Disord Year: 2020 Document type: Article