Proximal humeral fractures. Minimally invasive deltoid splitting versus deltopectoral approach: are there any advantages for one particular approach?

Background. The treatment of proximal humeral fractures has gained more and more importance in recent years as the increasing age of patients is accompanied by an increase of osteoporotic fractures. In this study the minimally invasive deltoid splitting approach (DS) and the deltopectoral approach (DP) in the surgical treatment of proximal humeral fractures with polyaxial locking non-contact bridging (NCB) plates were compared. Methods. A total of 120 patients were included in this randomized study. In addition to the collection of relevant treatment parameters (e.g. operation time, fluoroscopy time and length of stay in hospital), radiological and clinical examinations, such as Constant score, visual analogue scale (VAS) for pain and ADL, were taken at discharge, 6 weeks and 6 months postoperatively. Results. The age of the patients, operative time, fluoroscopy time and complication rates were comparable. With regard to the clinical examination after 6 months it can be seen in the Constant score that there is a tendency to an an advantage for the minimally invasive DS approach. Conclusion. The NCB plates can also be securely implanted by the minimally invasive DS approach. The access route may influence the clinical outcome.