Comparison of functional outcomes between direct lateral approach and deltopectoral approach in patients with proximal humeral fractures treated by plate osteosynthesis

Vol 28 | Issue 1 | Sep 2018 | page: 8-13 | Sutanu Hazra, Soham Mandal, Anirban Chatterjee, Vikash Kapoor

Authors: Sutanu Hazra[1], Soham Mandal [2], Anirban Chatterjee [1],
Vikash Kapoor [1]

[1] Medica Institute of Orthopedic Sciences, Medica Super
specialty Hospital, Kolkata.
[2] R G Kar Medical College & Hospital, Kolkata.

Address of Correspondence
Dr. Soham Mandal
R G Kar Medical College & Hospital, Kolkata.


Comparison Comparison of functional outcomes between direct lateral approach and deltopectoral approach in patients with proximal humeral fractures treated by plate osteosynthesis


Background: Plate osteosynthesis for proximal humeral fractures may be done either by the conventional deltopectoral approach or the direct lateral, deltoid splitting approach. There is sparse literature comparing these two approaches and their functional outcomes.
Methods: A retrospective study was conducted on 71 patients with proximal humerus fractures treated with locking plates (PHILOS®-plate). This is a retrospective study where the first 40 patients were operated using the Deltopectoral approach and the next 31 using the Deltoid splitting or direct lateral approach. Both the groups were comparable in terms of age and gender. Follow up was done at a 1-year interval for both the groups using the ‘Oxford Shoulder Score’.
Result: Duration of surgery and blood loss was found to be significantly lesser in the direct lateral approach group as compared to the Deltopectoral approach group. At 1 year follow up, the Oxford Shoulder Scores were found to be significantly better in the direct lateral group. There was one case of superficial infection and one case of axillary nerve paresis in the direct lateral group and none in the Deltopectoral group. There was one case of superficial infection, one case of plate impingement and one case of early plate removal in the deltopectoral group. Overall patient satisfaction was better in the deltoid splitting group.
Conclusion: The direct lateral approach is a new, safe and effective approach which can be used for fixation of proximal humerus fractures.
Keywords: Proximal humerus fractures, Deltopectoral approach, Deltoid Splitting approach


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How to Cite this Article: Hazra S, Mandal S, Chatterjee A, Kapoor V. Comparison of functional outcomes between direct lateral approach and deltopectoral approach in patients with proximal humeral fractures treated by plate osteosynthesis. International Journal of
Orthopaedic Surgery Sep. 2018;28(1):8-13.


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