Comparison Of The Deltoid Splitting Approach And The Traditional Deltopectoral Approach In Treatment Of Proximal Humerus Fractures

Objective:To discuss the advantages and disadvantages of two kinds of surgicalapproach,and respectively clinical practice value.Methods:From August2012to August2014,33patients with fracture of proximal humerus,who were treated in the Department of Orthopedic raumatology,The First BethuneHospital of Jilin University in China,were enrolled in this study.They were treatedwith PHILOS plate,and assigned to deltoid splitting approach group（n=13）whichwas Group A,and the deltopectoral approach group (n=20) was Group B.perioperativeindex,fracture healing time, postoperative functional recovery and Constant-Murleyshoulder score were compared between the two groups. For statisfical analysis, spss17.0were used.Results:The group A，operative time:79.54±7.30min；incision size:10.00±2.16cm；intraoperative blood loss:100.38±16.64ml；hospital stay:8.38±3.01d;healing time：102.07±14.07d； Constant-Murley score(3m，12m)：71.38±5.30，83.08±5.88。The group B,operative time:88.05±8.04min； incision size:13.45±2.26cm；intraoperative blood loss:119.00±24.63ml；hospital stay:8.90±3.61d;healing time：96.40±19.69d； Constant-Murley score(3m，12m)：64.55±5.12,79.15±7.19.Therewere no incision infection、nonunion、screw loosening in both groups,One case ofscrew cutout in the group A.There were statistically significant(P<0.05)differences inoperative time,incision size，intraoperative blood loss between the two groups，thegroup A better than group B. There were no statistically significant differencesbetween the two groups in healing time、Constant-Murley score(12m).But the group A was better than Group B in the aspects The early postoperative period(3months)Constant-Murley score better than the traditional approach.Conclusion：1.the deltoid splitting approach can be used as the first choice for the treatmentof proximal humeral fractures of aged patients and uncomplicate cases.2.the traditional deltopectoral approach can be used as the first choice for thetreatment of proximal humeral fractures of young patients and complicated cases.