Comparative Evaluation of Patient-reported Outcomes in Proximal Humeral Fracture: Deltoid-Splitting versus Deltopectoral Approaches.

Abstract

Background: Proximal humeral fractures (PHF) are common orthopedic injuries often associated with osteoporosis. Surgical approaches for PHF fixation, such as the deltopectoral and deltoid-splitting methods, have been a subject of debate. Additionally, patient satisfaction with these approaches has not been extensively studied among Iranian patients.

Materials and methods: A cross-sectional study was conducted on patients treated for PHF at a referral orthopedic center in Tehran, Iran, from 2019 to 2021. Two surgical techniques, deltopectoral and deltoid-splitting, were compared. Patient-reported outcomes in terms of patient satisfaction, including quality of life (SF-36), pain relief (VAS score), and shoulder function (Constant score), were assessed at six- and 12-month intervals postsurgery. Statistical analyses were performed to determine the differences between the two approaches.

Results: Among 148 patients, the majority were male (72.3%), 104 (70.3%) and 44 (29.7%) of patients were operated by deltopectoral and deltoid-splitting approaches, respectively. Patients' quality of life scored higher in the deltoid-splitting group both in six and one year following the surgical procedure; however, the observed differences did not reach statistical significance (P values 0.121 and 0.736, respectively). While there were slight variations in shoulder function and pain relief between the surgical approaches, none of these differences reached statistical significance.

Conclusion: This study suggests that both deltopectoral and deltoid-splitting surgical approaches for PHF treatment offer comparable patient satisfaction and functional outcomes. Surgeons can consider their expertise and patient-specific factors when selecting the appropriate approach for PHF fixation.