Deltopectoral vs deltoid split approach for proximal humerus fractures treated with locking plate: Our experience.

IF 2.3 Q2 ORTHOPEDICS
Calogero Cicio, Gianfranco Longo, Vito Pavone, Gianluca Testa, Rocco Ortuso, Giovanni C Salvo, Marco Ganci, Ignazio Prestianni, Alessio Ferrara, Antonio Kory, Alessandro Pietropaolo, Anna M Monachino, Enrica R Cuffaro, Giacomo Papotto
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引用次数: 0

Abstract

Background: Proximal humerus fractures (PHFs) are common, especially in the elderly, and optimal surgical management remains debated. This study compares clinical, functional, and radiographic outcomes of deltoid split (DS) vs deltopectoral (DP) approaches in PHFs treated with locking plates.

Aim: To evaluate and compare the clinical, functional, and radiographic outcomes-as well as postoperative complication rates-associated with the DS vs the DP surgical approach in the open reduction and internal fixation (ORIF) of PHFs using locking plate constructs.

Methods: A multicenter retrospective study of 120 patients undergoing ORIF for closed Neer type II-IV PHFs between January 2023 and December 2023. Patients were grouped by surgical approach [DS (n = 70), DP (n = 50)]. Outcome measures included Numeric Rating Scale (NRS) for pain, Quick-Disabilities in Arm, Shoulder, and Hand questionnaire (QuickDASH), Constant-Murley score, Short Form Health Survey-12v2, and radiographic alignment. Complication rates were recorded. Statistical significance was defined as P < 0.05.

Results: Early outcomes favored the DS group: (1) Lower NRS (3.1 vs 5.9); (2) Higher Constant-Murley (68.2 vs 50.5); and (3) Better QuickDASH (25.4 vs 37.1). Complication rate was lower in the DS group (1.66% vs 5.81%). Radiographic outcomes were comparable. Long-term results were similar between groups.

Conclusion: While both approaches yield satisfactory long-term outcomes, the DS approach is associated with faster early recovery and fewer complications, supporting its use in selected cases.

Abstract Image

Abstract Image

锁定钢板治疗肱骨近端骨折的三角胸肌与三角肌分离入路:我们的经验
背景:肱骨近端骨折(phf)是常见的,特别是在老年人中,最佳的手术治疗仍然存在争议。本研究比较了锁定钢板治疗phf时三角裂入路(DS)与三角直胸入路(DP)的临床、功能和影像学结果。目的:评估和比较DS与DP手术入路在使用锁定钢板结构的phf切开复位内固定(ORIF)中的临床、功能和影像学结果以及术后并发症发生率。方法:对2023年1月至2023年12月120例闭合性Neer II-IV型phf患者进行多中心回顾性研究。患者按手术入路分组[DS (n = 70), DP (n = 50)]。结果测量包括疼痛数值评定量表(NRS)、手臂、肩部和手部快速残疾问卷(QuickDASH)、Constant-Murley评分、简短健康调查-12v2和x线检查。记录并发症发生率。P < 0.05为差异有统计学意义。结果:早期结果有利于DS组:(1)较低的NRS (3.1 vs 5.9);(2)较高的Constant-Murley (68.2 vs 50.5);(3)更好的快跑(25.4 vs 37.1)。DS组并发症发生率较低(1.66% vs 5.81%)。影像学结果具有可比性。两组之间的长期结果相似。结论:虽然两种入路的长期疗效都令人满意,但DS入路具有更快的早期恢复和更少的并发症,支持在特定病例中使用。
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CiteScore
3.10
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