Comparative Study between Anterolateral and Posterior Approaches for Fracture Mid-Shaft of Humerus

This study aimed to compare the anterolateral and posterior approaches in terms of fracture union time, complication rates, and functional recovery in patients with mid-shaft humeral fractures.

A prospective observational study was conducted for 2 years on 60 mid-shaft humeral fracture patients; 38 patients were treated using the anterolateral approach and 22 patients with the posterior approach. Functional outcomes were measured using the disability of arm, shoulder, and hand (DASH) scores and shoulder and elbow range of motion at 3, 6, and 9 months. Data were analyzed using an independent t-test and Chi-square test or Fisher's exact test.

The mean age of patients in the anterolateral approach was 37.79 ± 12.484 years, whereas for the posterior approach it was 33.00 ± 10.619 years. There was a statistically significant difference (P < 0.05) in anterolateral and posterior approaches in terms of fracture union, mechanism of injury, postoperative complications, DASH scores, and shoulder and elbow range of motion. Radial nerve injury was reported in 5.3% and 22.7% of patients in the anterolateral and posterior approaches, respectively. There was a significant reduction (P < 0.05) in DASH scores in the anterolateral approach from 10.00 ± 8.85 at 3 months to 4.24 ± 1.99 at 9 months and in the posterior approach from 14.772 ± 10.29 at 3 months to 7.41 ± 5.35 at 9 months.

This study concluded that the anterolateral approach proves to be better than the posterior approach in terms of better union, lower complications, reduced risk of radial nerve injury, lower DASH scores, and significant improvement in shoulder and elbow range of motion.