Surgical Approach of Open Reduction and Internal Fixation for Proximal Humeral Fracture in the Elderly

Abstract

Background: The incidence of proximal humeral fracture is increasing gradually. Many patients choose open reduction and internal fixation. With the maturity of surgical technology and thought, people begin to think about the optimization of surgical effect from the surgical incision, including less trauma, less bleeding, less postoperative complications and fast postoperative recovery. However, due to the complexity of shoulder anatomy, scholars have created different surgical approaches from different perspectives. Objective: Although the effect of open reduction and internal fixation is confirmed, there are still some differences in the effect of different surgical approaches. We need to study the summary and research progress of surgical approach for proximal humeral fracture, which is conducive to the selection of the optimal approach for incision, so as to improve the prognosis. Method: Selective literature review. Result: At present, common surgical approaches include lateral approach, anteromedial approach, anterolateral approach, small incision approach and other approaches. This paper describes and compares the advantages and disadvantages of each approach, so as to choose the best approach for different fracture types. Conclusion: Based on the complexity of the anatomical relationship of the shoulder joint, the displacement, classification of the fracture, the proximal humerus are opened and exposed from different perspectives. Choosing a safe surgical approach is one of the key links of the whole operation and plays an important role in the postoperative effect. In this paper, the common approaches and new approaches of open reduction and internal fixation for proximal humeral fracture are reviewed, which provides new ideas for the design of surgical scheme.