Effect of the Treatment of Proximal Humeral Fractures with Locking Plate Internal Fixation Under Different Approaches

FAN Zhaoyang

doi:10.3969/j.issn.1004-437X.2026.13.020

Abstract：Objective To compare the clinical effects of locking plate internal fixation with different approaches in patients with proximal humeral fractures.Methods According to the random number table method,72 patients with proximal humeral fractures admitted to Nanyang Second General Hospital from July 2020 to July 2023 were divided into the deltoid approach group(36 cases,locking plate internal fixation transthoracic deltoid approach)and the minimally invasive deltoid approach group(36 cases,locking plate internal fixation through minimally invasive deltoid approach).The clinical related indexes,shoulder joint function and complications were compared between the two groups.Results The deltoid approach group had more intraoperative bleeding than the minimally invasive deltoid approach group,and the incision healing time and surgical time were longer than the minimally invasive deltoid approach group(P＜0.05).At 3 months and 6 months postoperatively,the constant murley shoulder joint score in the deltoid approach group was lower than that in the minimally invasive deltoid approach group(P＜0.05).The incidence of postoperative axillary nerve injury in the deltoid approach group was lower than that in the minimally invasive deltoid approach group,and the incidence of humeral head necrosis was higher than that in the minimally invasive deltoid approach group(P＜0.05).Conclusion Compared with the locking plate internal fixation through the pectoralis major deltoid approach,the locking plate internal fixation through the deltoid minimally invasive approach can shorten the operation time,incision healing time,reduce intraoperative blood loss,and promote early shoulder function recovery in patients with proximal humeral fractures.