Abstract:

Objective　To investigate the methods and clinical outcomes of the proximal humeral fracture treatment through extended anterolateral approach of deltoid-splitting approach.　Methods　From October 2010 to February 2014, 35 patients with proximal humeral fractures were treated through deltoid-splitting approach. According to the Neer classification: there were 12 cases of two-part fracture, 21 three-part fracture and 4 four-part fracture. The deltoid muscle was split from the gap of the front and middle and the axillary nerve was revealed and protected, thenthe fracture was fixed with anatomic locking plate after reduction.　Result　Thirty of 35 patients were followed up from 8 to 24 months. All fractures healed up. Axillary nerve injury was not found. According to Neer criteria for shoulder joint function: excellent in 16 cases, good in 8, fair in 3 cases, bad in 3 cases. The excellent and good rate was 80%.　Conclusion　The extended anterolateral acromial approach of deltoid-splitting can reveal and protect the axillary nerve effectively, and open reduction and plate fixation can be performed under direct vision. It has the advantage of the little trauma, less bleeding and convenient operation.

Key words:  Deltoid, Humerus, Axillary nerve, Fracture