Minimally Invasive versus Standard Open Deltopectoral approach in management of Proximal Humeral fractures

Abstract

Proximal humeral fractures contribute to 4 – 5 % of all fractures and accounts for 45 % of all humeral fractures. This type of fracture is considered the third most common fracture associated with osteoporosis after intertrochanteric fractures and distal radius fractures. Proximal humeral fractures may be stable or unstable fracture. Unstable fracture is identified by angulations of more than 45 degrees or displacement of more than 1 cm. Also unstable fracture is identified by Neer as displacement or angulations of two-part, three-part and four-part fractures. Now, many surgeons prefer to use humeral head preserving technique by using locked compressive low contact PHILOS plate. The anatomical design of this plate provides angular stability as it has many holes and surgeons are able to lock the screw in various directions in the head of the humerus. So this plate is better in providing more stability especially in osteoporotic bone, ensure less bone de-vascularization and less soft tissue damage. Many patients experience less pain and more shoulder range of motion.