Keywords : anterolateral approach
A study that compare anterolateral approach to posterior approach for the management of diaphyseal humerus fractures
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 2, Pages 2070-2080
Background: Diaphyseal humerus fractures have been treated by different approaches. Open reduction and internal fixation by plate osteosynthesis for diaphyseal humerus fracture can be done by anterolateral approach, posterior approach or minimal invasive plate osteosynthesis. There have been few trials or studies conducted to see which approach are most suitable for diaphyseal humerus fractures.
Objectives: To compare outcome of diaphyseal humerus fractures treated with open reduction and internal fixation with plate by two different approaches, anterolateral and posterior.
Methodology: It was prospective comparative study between two approaches of management of diaphysial humerus fracture. After primary assessment and stabilization of patient all routine hematological investigation and radiological investigation were done. Patients were explained about surgery, proper consent was taken and patients were prepared for operation. Each patient was assigned one of the management approaches randomly. Follow-up of patients was done postoperatively at six weeks, three months and six months and patients were assessed using American shoulder and elbow surgeon’s (ASES) scoring system.
Observations: According to Müller AO type simple transverse fractures were the most common type of fracture with 36.91% patients, followed by Simple spiral fracture (15.38%), Simple oblique fracture (11.53%), Bending wedge fracture (11.53%) and Fragmented wedge fractures (11.53%). 38.46% patients had excellent result among patients treated by anterolateral approach while 34.61% patients treated by posterior approach had excellent result. Among total 6 complications 4 were with anterolateral approach and 2 were with posterior approach.
Conclusion: Anterolateral approach is good option for upper third and middle third diaphyseal humerus fractures and posterior approach is better option for distal third diaphyseal humerus fractures.