Minimal invasive percutaneous plate osteosynthesis (MIPPO) through deltoid-pectoralis approach for the treatment of elderly proximal humeral fractures

Abstract

Background

Current treatments for proximal humeral fractures include conservative treatment, conventional open reduction internal fixation (ORIF) and MIPPO through deltoid-splitting approach. The aim of this study was to evaluate the clinical outcome of MIPPO versus ORIF via the deltoid-pectoralis approach in elderly patients with proximal humeral fractures.

Methods

Thirty-six patients with proximal humeral fractures were enrolled in this study. Following the randomized block and single-blinded principle, the patients were assigned to two groups and treated with either conventional ORIF or MIPPO, both through the deltoid-pectoralis approach. Surgical outcomes were evaluated by the NEER score, Constant-Murley score, blood loss, length of operation, radiological imaging and clinical examination. The patients were followed up for 4–24 (mean 10) months.

Results

According to Constant-Murley score, the surgical outcome was excellent in 14 cases, satisfactory in 2 cases and unsatisfactory in one case in MIPPO group versus 10, 5 and 4 in conventional ORIF group. MIPPO was significantly advantageous over conventional ORIF in terms of NEER score, Constant-Murley, length of operation and intraoperative blood loss. In addition, MIPPO was also more advantageous in several indexes in patients with BMI > 26.0 and NEER type III fracture.

Conclusion

The results of our study have demonstrated that MIPPO through the deltoid-pectoralis approach is an effective alternative for the treatment of proximal humeral fractures in elderly patients.

Trial registration

The trial registration number (TRN): ChiCTR-INR-17011098 (retrospectively registered at 2017-04-09)

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