Proximal humerus fracture-dislocation managed by mini-open reduction and percutaneous screw fixation

Area of Science:

• Orthopedic Surgery
• Traumatology
• Skeletal Repair

Background:

• Proximal humeral fractures are complex injuries.
• Minimally invasive techniques aim to preserve soft tissues.
• Fracture-dislocations present unique challenges.

Purpose of the Study:

• To describe and evaluate a minimally open reduction and percutaneous fixation technique.
• To assess the efficacy of this technique for three- and four-part proximal humeral fracture-dislocations.
• To compare outcomes with existing fixation methods.

Main Methods:

• Eleven patients with three- or four-part proximal humeral fracture-dislocations were treated.
• A mini-open deltopectoral approach with subscapularis split was used for reduction.
• Fracture fragments were fixed using percutaneous screws.
• Functional outcomes were assessed using Constant and Oxford Shoulder Scores.

Main Results:

• Mean Constant score was 75, compared to 88 for the uninjured shoulder.
• Mean Oxford Shoulder Score was 41.
• Complications included one case of avascular necrosis, three instances of screw back-out, and one radial nerve neuropraxia, all managed successfully.

Conclusions:

• The described technique is a promising approach for complex proximal humeral fractures.
• Outcomes are comparable to other fixation methods.
• Minimal soft tissue dissection contributes to a low complication rate.