[Anterolateral acromial approach for the treatment of proximal humerus in 2-or 3-part fractures-a case-control study]

To explore the clinical curative effect of anterolateral acromial approach in treating two-and three-part of proximal humeral fractures.

Forty-two patients of proximal humeral fractures from January 2010 to June 2014 were analyzed retrospectively, including 23 males and 19 females with a mean age of 61.5 years old ranging from 40 to 76 years old. Among them, 22 cases were treated with anterolateral acromial approach and 20 cases were treated with deltopectoral approach. The operation time, intraoperative blood loss, postoperative hospitalization days, fracture healing time of two groups were compared. The shoulder pain after 1 week was assessed by the VAS score. The postoperative shoulder joint function was evaluated after 3 months and more than 6 months by Constant score.

The follow-up time was at final 14 months. There were significant differences in operation time(P=0.003), intraoperative blood loss(P=0.001), postoperative hospital day(P=0.013), postoperative shoulder pain after 1 week(P=0.026), postoperative Constant score after 3 months(P=0.014) between the anterolateral acromial approach group and the deltopectoral approach group. There were no significant differences in clinical union time of bone(P=0.462), postoperative constant score after more than 6 months(P=0.204) between the anterolateral acromial approach group and the deltopectoral approach group. There were no breakage of the internal fixation and humeral head osteonecrosis.

It has some advantages with anterolateral acromial approach to treat Neer two-and three-part of proximal humeral fractures, such as short operation time, less intraoperative bleeding, lighter postoperative pain, quicker recovery of function.