Modified Trans-Deltoid Approach for Internal Fixation of Proximal Humeral Fracture | ||
| The Egyptian Orthopaedic Journal | ||
| Volume 60, Issue 3, September 2025, Pages 276-286 PDF (737.48 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/EOJ.2025.449743 | ||
| Authors | ||
| Mohamed K. El-Mesery* ; Mohamed S. Saeid; Muhammad A. Quolquela; El-Sayed M. El-Forse | ||
| Department of Orthopedic Surgery, Faculty of Medicine, Tanta University, Tanta, Egypt. | ||
| Abstract | ||
| Background This study evaluates outcomes of internal fixation of proximal humeral fracture using modified trans-deltoid procedure, focusing on functional results and complications. The conventional delto-pectoral procedure can be challenging for significantly displaced fractures, especially the greater tuberosity, and frequently necessitates a thorough dissection of soft tissues. In contrast, Trans-deltoid approach offers easier access but carries a possibility of axillary nerve injury. Patients and Methods A total of 23 patients participated in this prospective trial, both sexes, Neer’s type 2, 3, and 4. Depending on the fracture architecture, either a ‘two-window’ less invasive incision or a longer incision was made using a modified trans-deltoid technique. Utilizing the Constant–Murley shoulder score, functional results were analyzed. Results Neer’s classification categorized fractures as type 2(43.5%), type 3(39.1%), and type 4(17.4%). The mean Constant–Murley score for shoulder function at the last follow-up was 83.7 points, with 4.3% poor, 17.4% moderate, 21.7% good, and 56.5% excellent outcomes. No cases of postoperative axillary nerve palsy were reported. Conclusions The modified trans-deltoid approach is a practical and simple method for fixing proximal humeral fractures. It offers an early range of movement, little soft tissue damage, short operative time, better surgical exposure, and adequate accessibility for reduction and implant insertion. | ||
| Keywords | ||
| Deltoid splitting approach; Proximal humerus fracture; Trans-deltoid approach | ||
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