Treatment of proximal humeral fracture combined with lower glenoid fracture by internal fixation via the posterior axillary approach and the deltoid pectoralis major approach
10.3760/cma.j.cn115530-20220116-00030
- VernacularTitle:腋后路联合三角肌胸大肌入路内固定治疗肱骨近端骨折合并肩胛盂下部分骨折的疗效分析
- Author:
Fude JIAO
1
;
Yunqiang ZHUANG
;
Jingwei ZHANG
;
Jichong YING
;
Qing WANG
;
Jianming CHEN
;
Gangqiang JIANG
;
Dankai WU
Author Information
1. 宁波市第六医院创伤骨科，宁波 315040
- Keywords:
Shoulder joint;
Humeral fractures;
Fracture fixation, internal;
Glenoid fractures
- From:
Chinese Journal of Orthopaedic Trauma
2022;24(8):719-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of the posterior axillary approach combined with the deltoid pectoralis major approach in the treatment of proximal humeral fracture combined with lower glenoid fracture.Methods:From July 2019 to September 2021, 7 patients were treated at Department of Traumatic Othopeadics, The Sixth Hospital of Ningbo for proximal humeral fracture combined with lower glenoid fracture by internal fixation via the posterior axillary approach combined with the deltoid pectoralis major approach. They were 2 males and 5 females, aged from 51 to 78 years (average, 62.9 years). All fractures were closed ones. According to the Neer classification for the proximal humeral fractures, there were one case of type Ⅱ, one case of type Ⅲ, 3 cases of type Ⅳ and 2 cases of type Ⅵ. According to the Ideberg classification for the glenoid fractures, 5 cases were type Ⅰ and 2 cases type Ⅱ. The anteroposterior, lateral and axillary X-ray films of the affected shoulder were taken at 6 and 12 weeks, and 6 and 12 months after operation to follow up fracture healing and occurrence of complications. The Constant-Murley shoulder joint scores and the Disability of Arm Shoulder and Hand (DASH) scores for the upper limb dysfunction were recorded at the last follow-up for all patients.Results:All the 7 patients were followed up for 8 to 15 months (mean, 11.9 months). Bone union was achieved after an average of 4.3 months (from 3 to 6 months) in all patients. None of the functional activities was affected in all by postoperative shoulder joint instability, incision infection or axillary scar hyperplasia. At the last follow-up, their Constant-Murley scores averaged 83.4 points (from 55 to 92 points), and their DASH scores 13.5 points (from 4.2 to 33.3 points).Conclusion:In the treatment of proximal humeral fracture combined with lower glenoid fracture, the posterior axillary approach combined with the deltoid pectoralis major approach can lead to fine early curative efficacy due to their advantageous possibilities to allow for easy fracture reduction, reliable fixation and early rehabilitation.
