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Clin Shoulder Elbow > Volume 16(1); 2013 > Article
Clinics in Shoulder and Elbow 2013;16(1):17-26.
DOI: https://doi.org/10.5397/CiSE.2013.16.1.17    Published online June 30, 2013.
Comparison Study of Different Approach (Deltoid Splitting Approach and Delto-pectoral Interval Approach) for Proximal Humeral Fractures
Seung Hee Kim, Jinmyoung Dan, Byoung Kook Kim, Yun Seok Lee, Hyoeng Jung Kim, Keun Jeong Ryu, Jin Hyun Lee, Jae Hwa Kim
1Department of Orthopedic Surgery, Gumi CHA Hospital, CHA Medical University, Korea. osjmdan@gmail.com
2Department of Orthopedic Surgery, Bundang CHA Hospital College of Medicine, CHA Medical University, Korea.
근위 상완골 골절의 수술적 치료에서 삼각근 분할 도달법과 삼각 대흉간 도달법의 임상적, 방사선학적 추시 결과 비교
김승희·단진명·김병국·이윤석·김형종*·류근정*·이진현*·김재화*
차의과학대학교 구미차병원 정형외과학교실, 분당차병원 정형외과학교실*
Abstract
PURPOSE
A comparison of the radiographic and the clinical outcomes between two different surgical approaches-Deltoid splitting and Delto-pectoral interval-on the proximal humerus fractures treated by locking compressive plate (LCP), is done. MATERIALS AND METHODS: Medical records and pre- and postoperative radiographs were reviewed retrospectively for 75 adult patients who underwent surgical fixations with locking compressive plates from May 2005 to December 2011. Patients were divided into two groups according to the surgical methods. Differences in the neck-shaft angle between immediate postoperative period and final follow-up were compared between the two groups. Differences in constant score and Korean shoulder score (KSS) between affected arms and contralateral arms at final follow-up were also compared.
RESULTS
The differences in the neck-shaft angle between immediate postoperative period and at final follow-up was 12.04 degrees on average in Deltoid splitting approach and 10.20 degrees in Delto-pectoral interval approach, which was not statistically significant. Differences in constant score/KSS between the affected arm and the contralateral arm were 13.78/22.74 points in deltoid-splitting approach on average and 19.41/31.13 points in Delto-pectoral interval approach, showing that deltoid-splitting approach is significantly superior.
CONCLUSION
Deltoid-splitting approach showed better functional outcomes in the fracture reduction and internal fixation using LCP for the treatment of unstable proximal humerus fractures.
Key Words: Proximal humeral fracture; Deltoid splitting approach; Delto-pectoral interval approach; Locking compression plate


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