A comparative study of the minimally invasive lateral shoulder approach and deltopectoral space approach for the treatment of proximal humerus fractures

Objective: To compare the clinical efficacy of the minimally invasive lateral shoulder approach and deltopectoral space approach in the treatment of proximal humerus fractures.

Methods: The clinical data of 95 patients with proximal humerus fractures admitted to the hospital from June 2018 to June 2023 were retrospectively collected. Forty-four patients were treated with a minimally invasive lateral shoulder approach (study group), and 51 patients were treated with a deltopectoral space approach (control group). The baseline data (age, sex, mechanism of injury, preoperative Neer classification, and time from injury to surgery), operation time, intraoperative blood loss, incision length, fracture healing time, and postoperative complications were compared between these two groups. The VAS score, shoulder range of motion (ROM) score, and Constant-Murley score were used to evaluate the shoulder joint function of the two groups one year after surgery.

Results: There were no significant differences in operation time, blood loss, incision length or fracture healing time between the two groups (P > 0.05). The incidence of postoperative complications in the study group was significantly lower than that in the control group, and the difference between the groups was statistically significant (P < 0.05). There was no significant difference in shoulder joint function or VAS score between the two groups one year after surgery (P > 0.05).

Conclusion: The treatment of proximal humerus fractures via the lateral shoulder approach is minimally invasive and can reduce the occurrence of complications such as ischemic necrosis of the humerus head, relieve shoulder pain in the short term, and restore good shoulder function. Therefore, given the strict grasp of indications and familiarity with surgical operations, the minimally invasive lateral shoulder approach for the treatment of proximal humeral fractures is safe and effective and is worth promoting and applying in clinical practice.