Anterolateral and medial approach fixation with compression plate and screw for middle and inferior humeral fractures：efficacy and safety

Wu Wei; Wang Hai-bo

doi:10.3969/j.issn.2095-4344.2015.31.017

Abstract：BACKGROUND:Reduction and fixation are presently used for middle and inferior humeral fractures. The methods of fixation approach include anterolateral (including modified upper arm anterolateral), posterior and medial approaches. The repair approach of middle and inferior humeral fractures remains controversial. OBJECTIVE:To compare efficiency and safety of anterolateral and medial approach fixation with compression plate and screw for middle and inferior humeral fractures. METHODS:A total of 90 cases of middle and inferior humeral fractures treated in Chongqing Red Cross Hospital were equaly and randomly divided into experimental group and control group. In the control group, patients were subjected to compression plate and screw through anterolateral approach. In the experimental group, patients were subjected to compression plate and screw through medial approach. Operation time, intraoperative blood loss, complications and the recovery of shoulder joint and elbow joint function were compared in patients of both groups. RESULTS AND CONCLUSION:Intraoperative blood loss was significantly lower in the experimental group than in the control group (P < 0.05). No significant difference in operation time and fracture healing time was found between the two groups (P > 0.05). During 6 months of folow-up, no significant difference in shoulder joint function Neer score and elbow joint function Mayo score was detected between the two groups (P > 0.05). During the folow-up period, no wound infection, bone nonunion or chronic osteomyelitis appeared in both groups. These data confirm that the effects of medial approach and anterolateral approach for middle and inferior humeral fractures are similar. Medial approach leads to less blood loss, can effectively make up for the defects of the traditional repair scheme, and can be considered as one of fixation approach for middle and inferior humeral fractures.