Background: The incidence of proximal humeral fracture is increasing gradually. Many patients choose open reduction and internal fixation. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complications and fast postoperative recovery. However, due to the complexity of shoulder anatomy, scholars have created different surgical approaches from different perspectives. Objective: Although the effect of open reduction and internal fixation is confirmed, there are still some differences in the effect of different surgical approaches. We need to study the summary and research progress of surgical approach for proximal humeral fracture, which is conducive to the selection of the optimal approach for incision, so as to improve the prognosis. Method: Selective literature review. Result: At present, common surgical approaches include lateral approach, anteromedial approach, anterolateral approach, small incision approach and other approaches. This paper describes and compares the advantages and disadvantages of each approach, so as to choose the best approach for different fracture types. Conclusion: Based on the complexity of the anatomical relationship of the shoulder joint, the displacement, classification of the fracture, the proximal humerus are opened and exposed from different perspectives. Choosing a safe surgical approach is one of the key links of the whole operation and plays an important role in the postoperative effect. In this paper, the common approaches and new approaches of open reduction and internal fixation for proximal humeral fracture are reviewed, which provides new ideas for the design of surgical scheme.
| Published in | Journal of Surgery (Volume 8, Issue 2) |
| DOI | 10.11648/j.js.20200802.13 |
| Page(s) | 56-61 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2020. Published by Science Publishing Group |
Surgical Approach, Proximal Humeral Fracture, Open Reduction, Internal Fixation
| [1] | Burkhart KJ. The treatment of proximal humeral fracture in adults. [J]. Deutsches Ärzteblatt International, Vol. 110, No. 35-36, 2013, pp. 591-597. |
| [2] | Carroll EA, Schweppe M, Langfitt M, et al. Management of humeral shaft fractures [J]. The Journal of the American Academy of Orthopaedic Surgeons. Vol. 20, No 7, 2012, pp. 423-433. |
| [3] | Aaron D, Shatsky J, Paredes JC, et al. Proximal humeral fractures: internal fixation. [J]. Journal of Bone & Joint Surgery American Volume, Vol. 94, No. 24, 2012, pp. 2280-8. |
| [4] | Hessmann MH, Hansen WSM, Krummenauer F, et al. Locked Plate Fixation and Intramedullary Nailing for Proximal Humerus Fractures: A Biomechanical Evaluation [J]. The Journal of Trauma: Injury, Infection, and Critical Care, Vol. 58, No. 6, 2005, pp. 1194-1201. |
| [5] | Palvanen M, Kannus P, Niemi S, et al. Update in the epidemiology of proximal humeral fractures [J]. Clinical Orthopaedics & Related Research, Vol. 442, 2006, pp. 87-92. |
| [6] | Lind T, Krøner K, Jensen J. The epidemiology of fractures of the proximal humerus [J]. Archives of Orthopaedic & Trauma Surgery. Vol. 105, No. 5, 1989, pp. 285-287. |
| [7] | Gaebler C. Minimally displaced proximal humeral fractures. Epidemiology and outcome in 507 cases [J]. Acta Orthop Scand. Vol. 74, No. 5, 2003, pp. 580-5. |
| [8] | Agudelo J, Schürmann, Matthias, Stahel P, et al. Analysis of Efficacy and Failure in Proximal Humerus Fractures Treated With Locking Plates [J]. Journal of Orthopaedic Trauma, Vol. 21, No. 10, 2007, pp. 676-681. |
| [9] | Bell JE, Leung BC, Spratt KF, et al. Trends and Variation in Incidence, Surgical Treatment, and Repeat Surgery of Proximal Humeral Fractures in the Elderly [J]. Journal of Bone & Joint Surgery American Volume, Vol. 93, No. 2, 2011, pp. 121-31. |
| [10] | Burkhead WZ, Scheinberg RR, Box G. Surgical anatomy of the axillary nerve [J]. Journal of Shoulder and Elbow Surgery, Vol. 1, No. 1, 1992, pp. 31-36. |
| [11] | Marion B, Leclère, Franck M, et al. Potential axillary nerve stretching during RSA implantation: an anatomical study [J]. Anatomical Science International, Vol. 89, No. 4, 2014, pp. 232-237. |
| [12] | Menck J, Döbler A, Döhler JR.[Vascularization of the humerus] [J]. Langenbecks Archiv Für Chirurgie. Vol. 382, No. 3, 1997, pp. 123-127. |
| [13] | Korkmaz MF, Erdem MN, Karakaplan M, et al. [Comparison of lateral deltoid splitting and deltopectoral approaches in the treatment of proximal humerus fractures] [J]. Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery: TJTES. Vol. 21, No. 2, 2015, pp. 113-118. |
| [14] | Gardner MJ, Griffith MH, Dines JS, et al. The extended anterolateral acromial approach allows minimally invasive access to the proximal humerus [J]. Clinical orthopaedics and related research. No. 434, 2005, pp. 123-129. |
| [15] | Khan LAK, Robinson CM, Will E, et al. Assessment of axillary nerve function and functional outcome after fixation of complex proximal humeral fractures using the extended deltoid-splitting approach [J]. Injury-international Journal of the Care of the Injured, Vol. 40, No. 2, 2009, pp. 181-185. |
| [16] | Gardner MJ, Griffith MH, Dines JS, et al. A minimally invasive approach for plate fixation of the proximal humerus [J]. Bulletin. Vol. 62, No. 1-2, 2004, pp. 18-23. |
| [17] | Cameron BD, Williams GR. Operative Fixation of Three-Part Proximal Humerus Fractures [J]. Techniques in Shoulder & Elbow Surgery. Vol. 3, No. 2, 2002, pp. 111-123. |
| [18] | Theodore FS, Richard JH. Displaced Proximal Humeral Fractures: Evaluation and Treatment [J]. Journal of the American Academy of Orthopaedic Surgeons. Vol. 2, No. 1, 1994, pp. 54-78. |
| [19] | Chou YC, Tseng IC, Chiang CW, et al. Shoulder hemiarthroplasty for proximal humeral fractures: comparisons between the deltopectoral and anterolateral deltoid-splitting approaches [J]. Journal of Shoulder and Elbow Surgery, Vol. 22, No. 8, 2013, pp. e1-e7. |
| [20] | Harmer LS, Crickard CV, Phelps KD, et al. Surgical Approaches to the Proximal Humerus: A Quantitative Comparison of the Deltopectoral Approach and the Anterolateral Acromial Approach. Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews. Vol. 2, No. 6, 2018, pp. e017. |
| [21] | Abbott LC, Saunders JBD. Surgical approaches to the shoulder joint. [J]. Journal of Bone & Joint Surgery American Volume, Vol. 31A, No. 2, 1949, pp. 235. |
| [22] | Robinson CM, Khan L, Akhtar A, et al. The Extended Deltoid-Splitting Approach to the Proximal Humerus [J]. Journal of Orthopaedic Trauma, Vol. 21, No. 9, 2007, pp. 657-662. |
| [23] | Flatow EL, Cuomo F, Maday MG, et al. Open reduction and internal fixation of two-part displaced fractures of the greater tuberosity of the proximal part of the humerus. [J]. Journal of Bone & Joint Surgery-american Volume, Vol. 73, No. 8, 1991, pp. 1213-1218. |
| [24] | Argyropoulos M, Kent M. Early Results of the A. L. P. S. Proximal Humerus Locking Plate [J]. The Open Orthopaedics Journal, Vol. 12, No. 1, 2018, pp. 53-58. |
| [25] | Konrad G, Laurent Audigé, Lambert S, et al. Similar Outcomes for Nail versus Plate Fixation of Three-part Proximal Humeral Fractures [J]. Clinical Orthopaedics & Related Research, Vol. 470, No. 2, 2012, pp. 602-609. |
| [26] | Saran N, Bergeron SG, Benoit B, et al. Risk of axillary nerve injury during percutaneous proximal humerus locking plate insertion using an external aiming guide [J]. Injury, Vol. 41, No. 10, 2010, pp. 1037-1040. |
| [27] | Wijgman AJ, Roolker W, Patt TW, et al. Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus [J]. J Bone Joint Surg Am. Vol. 84, No. 11, 2002, pp. 1919-25. |
| [28] | Cadet ER, Ahmad CS. Hemiarthroplasty for Three- and Four-part Proximal Humerus Fractures [J]. Journal of the American Academy of Orthopaedic Surgeons, Vol. 20, No. 1, 2010, pp. 17-27. |
| [29] | Gerber C, Schneeberger AG, Vinh TS. The arterial vascularization of the humeral head. An anatomical study. [J]. Journal of Bone & Joint Surgery-american Volume, Vol. 72, No. 10, 1990, pp. 1486-1494. |
| [30] | Hettrich, Carolyn M. Quantitative Assessment of the Vascularity of the Proximal Part of the Humerus [J]. The Journal of Bone and Joint Surgery (American), Vol. 92, No. 4, 2010, pp. 943. |
| [31] | Gardner MJ, Boraiah S, Helfet DL, et al. The anterolateral acromial approach for fractures of the proximal humerus [J]. Journal of orthopaedic trauma. Vol. 22, No. 2, 2008, pp. 132-137. |
| [32] | Robinson CM, Murray IR. The extended deltoid-splitting approach to the proximal humerus: VARIATIONS AND EXTENSIONS [J]. The Bone & Joint Journal, Vol. 93-B, No. 3, 2011, pp. 387-392. |
| [33] | Gardner MJ, Voos JE, Wanich T, et al. Vascular implications of minimally invasive plating of proximal humerus fractures [J]. Journal of orthopaedic trauma. Vol. 20, No. 9, 2006, pp. 602-607. |
| [34] | Rancan M, Dietrich M, Lamdark T, et al. Minimal invasive long PHILOS?-plate osteosynthesis in metadiaphyseal fractures of the proximal humerus [J]. Injury-international Journal of the Care of the Injured, Vol. 41, No. 12, 2010, pp. 1277-1283. |
| [35] | Stecco C, Gagliano G, Lancerotto L, et al. Surgical anatomy of the axillary nerve and its implication in the transdeltoid approaches to the shoulder [J]. J Shoulder Elbow Surg, Vol. 19, No. 8, 2010, pp. 0-1174. |
| [36] | Boesmueller S, Wech M, Gregori M, et al. Risk Factors for Humeral Head Necrosis and Non-Union After Plating in Proximal Humeral Fractures [J]. Injury, Vol. 47, No. 2, 2015, pp. 350-355. |
| [37] | Isiklar Z, Kormaz F, Gogus A, et al. COMPARISION OF DELTOPECTORAL VERSUS LATERAL DELTOID SPLIT APPROACH IN OPERATIVE TREATMENT OF PROXIMAL HUMERAL FRACTURES. 2010. |
| [38] | Buecking B, Mohr J, Bockmann B, et al. Deltoid-split or Deltopectoral Approaches for the Treatment of Displaced Proximal Humeral Fractures? [J]. Clinical Orthopaedics and Related Research, Vol. 472, No. 5, 2014, pp. 1576-1585. |
| [39] | Tingart MJ, Lehtinen J, Zurakowski D, et al. Proximal humeral fractures: Regional differences in bone mineral density of the humeral head affect the fixation strength of cancellous screws [J]. Journal of Shoulder & Elbow Surgery, Vol. 15, No. 5, 2006, pp. 0-624. |
| [40] | Zhao L, Yang P, Zhu L, et al. Minimal invasive percutaneous plate osteosynthesis (MIPPO) through deltoid-pectoralis approach for the treatment of elderly proximal humeral fractures [J]. Bmc Musculoskelet Disord. Vol. 18, No. 1, 2017, pp. 187. |
| [41] | Acklin YP, Sommer C. Plattenosteosynthese von proximalen Humerusfrakturen über den minimalinvasiven anterolateralen Deltasplit-Zugang [J]. Operative Orthopädie Und Traumatologie, Vol. 24, No. 1, 2012, pp. 61-73. |
| [42] | Apaydin N, Tubbs RS, Loukas M, et al. Review of the surgical anatomy of the axillary nerve and the anatomic basis of its iatrogenic and traumatic injury [J]. Surgical & Radiologic Anatomy, Vol. 32, No. 3, 2010, pp. 193-201. |
| [43] | Sohn HS, Jeon YS, Lee JH, et al. Clinical comparison between open plating and minimally invasive plate osteosynthesis for displaced proximal humeral fractures: A prospective randomized controlled trial [J]. Injury, Vol. 48, No. 6, 2017, pp. 1175-1182. |
| [44] | Handoll HH, Madhok R. Interventions for treating proximal humeral fractures in adults [J]. Cochrane Database of Systematic Reviews, No. 4, 2003. |
| [45] | Ruchholtz S, Hauk C, Lewan U, et al. Minimally Invasive Polyaxial Locking Plate Fixation of Proximal Humeral Fractures: A Prospective Study [J]. Journal of Trauma. Vol. 71, No. 6, 2011, pp. 1737-1744. |
| [46] | Luigi AR, Matteo DR, Alberto GF. Minimally Invasive Plate Osteosynthesis for Proximal Humerus Fractures: A Retrospective Study Describing Principles and Advantages of the Technique [J]. Advances in Orthopedics, Vol. 2018, 2018, pp. 1-10. |
| [47] | D. B, Mackenzie. The antero-superior exposure for total shoulder replacement [J]. Journal of Shoulder and Elbow Surgery, 1996. |
| [48] | Mouraria GG, Zoppi A, Kikuta FK, et al. ANTEROLATERAL APPROACHES FOR PROXIMAL HUMERAL OSTEOSYNTHESIS: A SYSTEMATIC REVIEW [J]. Acta ortopedica brasileira. Vol. 27, No. 3, 2019, pp. 178-182. |
| [49] | Ting M, Kusnezov N, Dunn JC, et al. The Deltoid Lift: A Cadaveric Analysis and the Literature Review of a Novel Surgical Approach to the Proximal Humerus [J]. Techniques in hand & upper extremity surgery, Vol. 19, No. 3, 2015, pp. 120-123. |
| [50] | Gallo RA, Zeiders GJ, Altman GT. Two-incision technique for treatment of complex proximal humerus fractures [J]. Journal of orthopaedic trauma. Vol. 19, No. 10, 2005, pp. 734-740. |
APA Style
Liu Rui Jia, Meng Qing Qi, Li Si Ming. (2020). Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly. Journal of Surgery, 8(2), 56-61. https://doi.org/10.11648/j.js.20200802.13
ACS Style
Liu Rui Jia; Meng Qing Qi; Li Si Ming. Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly. J. Surg. 2020, 8(2), 56-61. doi: 10.11648/j.js.20200802.13
AMA Style
Liu Rui Jia, Meng Qing Qi, Li Si Ming. Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly. J Surg. 2020;8(2):56-61. doi: 10.11648/j.js.20200802.13
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Download@article{10.11648/j.js.20200802.13,
author = {Liu Rui Jia and Meng Qing Qi and Li Si Ming},
title = {Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly},
journal = {Journal of Surgery},
volume = {8},
number = {2},
pages = {56-61},
doi = {10.11648/j.js.20200802.13},
url = {https://doi.org/10.11648/j.js.20200802.13},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200802.13},
abstract = {Background: The incidence of proximal humeral fracture is increasing gradually. Many patients choose open reduction and internal fixation. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complications and fast postoperative recovery. However, due to the complexity of shoulder anatomy, scholars have created different surgical approaches from different perspectives. Objective: Although the effect of open reduction and internal fixation is confirmed, there are still some differences in the effect of different surgical approaches. We need to study the summary and research progress of surgical approach for proximal humeral fracture, which is conducive to the selection of the optimal approach for incision, so as to improve the prognosis. Method: Selective literature review. Result: At present, common surgical approaches include lateral approach, anteromedial approach, anterolateral approach, small incision approach and other approaches. This paper describes and compares the advantages and disadvantages of each approach, so as to choose the best approach for different fracture types. Conclusion: Based on the complexity of the anatomical relationship of the shoulder joint, the displacement, classification of the fracture, the proximal humerus are opened and exposed from different perspectives. Choosing a safe surgical approach is one of the key links of the whole operation and plays an important role in the postoperative effect. In this paper, the common approaches and new approaches of open reduction and internal fixation for proximal humeral fracture are reviewed, which provides new ideas for the design of surgical scheme.},
year = {2020}
}
TY - JOUR T1 - Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly AU - Liu Rui Jia AU - Meng Qing Qi AU - Li Si Ming Y1 - 2020/03/18 PY - 2020 N1 - https://doi.org/10.11648/j.js.20200802.13 DO - 10.11648/j.js.20200802.13 T2 - Journal of Surgery JF - Journal of Surgery JO - Journal of Surgery SP - 56 EP - 61 PB - Science Publishing Group SN - 2330-0930 UR - https://doi.org/10.11648/j.js.20200802.13 AB - Background: The incidence of proximal humeral fracture is increasing gradually. Many patients choose open reduction and internal fixation. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complications and fast postoperative recovery. However, due to the complexity of shoulder anatomy, scholars have created different surgical approaches from different perspectives. Objective: Although the effect of open reduction and internal fixation is confirmed, there are still some differences in the effect of different surgical approaches. We need to study the summary and research progress of surgical approach for proximal humeral fracture, which is conducive to the selection of the optimal approach for incision, so as to improve the prognosis. Method: Selective literature review. Result: At present, common surgical approaches include lateral approach, anteromedial approach, anterolateral approach, small incision approach and other approaches. This paper describes and compares the advantages and disadvantages of each approach, so as to choose the best approach for different fracture types. Conclusion: Based on the complexity of the anatomical relationship of the shoulder joint, the displacement, classification of the fracture, the proximal humerus are opened and exposed from different perspectives. Choosing a safe surgical approach is one of the key links of the whole operation and plays an important role in the postoperative effect. In this paper, the common approaches and new approaches of open reduction and internal fixation for proximal humeral fracture are reviewed, which provides new ideas for the design of surgical scheme. VL - 8 IS - 2 ER -
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