Proximal humerus fractures: deltopectoral open reduction and internal fixation vs deltosplit minimally invasive plate osteosynthesis: which surgical approach provides superior results?

Abstract

Proximal humeral fractures (PHFs) are one of the most common types of fractures, accounting for up to 5% of all fractures, and they are the third most common fracture in the elderly population, increased by more than three times between 1970 and 2002 (1, 2, 3, 4). By 2030, the incidence of PHFs is expected to further grow, due to the ageing population and a more active lifestyle among the elderly (4). The treatment strategy of PHFs depends on different aspects: patient characteristics (age and co-morbidity), injury patterns (fracture type and displacement), and different available options about the surgical technique (5, 6, 7). The majority of PHFs are undisplaced or minimally displaced, thus treated conservatively, while displaced or unstable fractures require surgical treatment to achieve an optimal functional outcome (8, 9). Various surgical techniques, like open reduction and internal fixation (ORIF) with proximal humeral plate, intramedullary nailing, and arthroplasty, have been described in the literature (10, 11). In recent years, the locking plate has become increasingly used for the fixation of PHFs, especially for elderly patients (12, 13, 14).

Keywords

• proximal humeral fracture
• phf
• deltosplit
• deltopectoral
• neer classification
• mipo
• orif