Open AccessOpen reduction and internal fixation of displaced head-split type humeral fractures and role of the rotator-interval approach
Author(s) -
Evi Fleischhacker,
Georg Siebenbürger,
Johannes Gleich,
Tobias Helfen,
Wolfgang Böcker,
Ben Ockert
Publication year - 2021
Publication title -
shoulder and elbow
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.506
H-Index - 15
eISSN - 1758-5740
pISSN - 1758-5732
DOI - 10.1177/17585732211065449
Subject(s) - medicine , dash , internal fixation , reduction (mathematics) , surgery , retrospective cohort study , radiography , fixation (population genetics) , nuclear medicine , computer science , operating system , population , geometry , mathematics , environmental health
Background Open reduction and internal fixation (ORIF) of humeral head split fractures is challenging because of high instability and limited visibility. The aim of this retrospective study was to investigate the extend of the approach through the rotator interval (RI) on the reduction quality and functional outcome.Methods 37 patients (mean age: 59 ± 16 years,16 female) treated by ORIF through a standard deltopectoral (DP) approach were evaluated. The follow-up period was at least two years. In 17 cases, the approach was extended through the RI. Evaluation was based on radiographs, Constant scores (CS) and DASH scores.Results In group DP, “anatomic” reduction was achieved in 9 cases (45%), “acceptable” in 5 cases (25%), and “malreduced” in 6 cases (30%). In group RI, “anatomic” reduction was seen in 12 cases (71%), “acceptable” in 5 cases (29%), and “malreduced” in none (p = 0.04). In the DP group, the CS was 60.2 ± 16.2 and the %CS was 63.9 ± 22.3, while in the RI group, the CS was 74.5 ± 17.4 and the %CS was 79.1 ± 24.1 (p = 0.07, p = 0.08). DASH score was 22.8 ± 19.5 in DP compared to RI: 25.2 ± 20.6 (p = 0.53).Conclusions The RI approach improves visualization as it enhances quality of fracture reduction, however functional outcomes may not differ significantly.Type of study and level of proof Retrospective, level III