Comparison of Posterior and Anterolateral Surgical Approaches in Treating Adult Humeral Shaft Fractures

The purpose of this study is to compare the outcomes and complications of two different surgical approaches, the anterolateral and posterior approaches, for treating humeral shaft fractures.

Between January 2015 and May 2021, 51 patients with humeral shaft fractures were treated with anterolateral and posterior approaches. Twenty-nine patients were operated with the posterior approach (group 1) and 22 with the anterolateral approach (group 2). Statistical analyses were performed between the two groups regarding age, gender distribution, fractured side, body mass index (BMI), type of trauma, Arbeitsgemeinschaft für Osteosynthesefragen/Orthopaedic Trauma Association (AO/OTA) classification, and follow-up time. Complications such as operative time, amount of bleeding, incision length and implant fracture, radial nerve palsy, wound infection, and nonunion were compared between the two groups. Functional results of the elbow joint were evaluated with the Mayo Elbow Performance Score.

The mean follow-up period was 49.10±21.15 months (12-75 months) in group 1 and 50.00±23.71 months (range: 15-70 months) in group 2. There was no statistical difference between the groups in terms of age, gender distribution, fractured side, BMI, trauma type, AO/OTA classification, and follow-up time (p>0.05). There was no significant difference between the two groups in terms of operation time, intraoperative bleeding, and incision length (p>0.05). The mean Mayo Elbow Performance Score was 77.24±20.03 (range: 70-100 points) in group 1 and 81.36±8.34 (range: 70-100 points) in group 2, and no significant difference was found (p>0.05). When evaluated in terms of complications, there was no significant difference between the groups (p>0.05). While there was no significant difference between the two groups regarding elbow joint range of motion, the limitation was observed in more patients in group 1.

Similar satisfactory treatment results were obtained in patients who underwent anterolateral and posterior approaches in treating humeral shaft fractures. Furthermore, no difference was found between the two approaches regarding complication rates.