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PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH
OBJECTIVE: The main surgical approach in proximal humeral fractures is the deltopectoral approach. Many surgeons avoid the anterolateral approach, fearing its complications, especially axillary nerve injury. The objective of this study is to evaluate shoulder function and complications in patients w...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
ATHA EDITORA
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699393/ https://www.ncbi.nlm.nih.gov/pubmed/31452616 http://dx.doi.org/10.1590/1413-785220192703218226 |
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author | Mouraria, Guilherme Grisi Zoppi, Américo Kikuta, Fernando Kenji Moratelli, Lucas Silveira, Paulo Pedroso Etchebehere, Maurício |
author_facet | Mouraria, Guilherme Grisi Zoppi, Américo Kikuta, Fernando Kenji Moratelli, Lucas Silveira, Paulo Pedroso Etchebehere, Maurício |
author_sort | Mouraria, Guilherme Grisi |
collection | PubMed |
description | OBJECTIVE: The main surgical approach in proximal humeral fractures is the deltopectoral approach. Many surgeons avoid the anterolateral approach, fearing its complications, especially axillary nerve injury. The objective of this study is to evaluate shoulder function and complications in patients with proximal humeral fractures treated using an anterolateral approach with direct observation of the axillary nerve. METHODS: Retrospective study with postoperative radiological and functional evaluations (Constant and DASH scores) and review of the complications. The associations between fracture classification and the difference in Constant scores among the subjects and the final angle of consolidation were analyzed using Fisher's test or analysis of variance (ANOVA). The Constant scores were compared among the shoulders using the paired t-test. RESULTS: The study evaluated 35 patients. Shoulder function was decreased, compared with the contralateral side (p<0.005). The only factor related to functional worsening was the Neer IV fracture. The main complication was malunion. There were no clinical changes related to the axillary nerve. CONCLUSION: The treatment using the extended anterolateral approach produced good functional results, although the function was decreased (Neer IV fractures). The main complication was malunion. There were no side effects due to exposure of the axillary nerve. Level of evidence III, Retrospective Study. |
format | Online Article Text |
id | pubmed-6699393 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | ATHA EDITORA |
record_format | MEDLINE/PubMed |
spelling | pubmed-66993932019-08-26 PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH Mouraria, Guilherme Grisi Zoppi, Américo Kikuta, Fernando Kenji Moratelli, Lucas Silveira, Paulo Pedroso Etchebehere, Maurício Acta Ortop Bras Original Article OBJECTIVE: The main surgical approach in proximal humeral fractures is the deltopectoral approach. Many surgeons avoid the anterolateral approach, fearing its complications, especially axillary nerve injury. The objective of this study is to evaluate shoulder function and complications in patients with proximal humeral fractures treated using an anterolateral approach with direct observation of the axillary nerve. METHODS: Retrospective study with postoperative radiological and functional evaluations (Constant and DASH scores) and review of the complications. The associations between fracture classification and the difference in Constant scores among the subjects and the final angle of consolidation were analyzed using Fisher's test or analysis of variance (ANOVA). The Constant scores were compared among the shoulders using the paired t-test. RESULTS: The study evaluated 35 patients. Shoulder function was decreased, compared with the contralateral side (p<0.005). The only factor related to functional worsening was the Neer IV fracture. The main complication was malunion. There were no clinical changes related to the axillary nerve. CONCLUSION: The treatment using the extended anterolateral approach produced good functional results, although the function was decreased (Neer IV fractures). The main complication was malunion. There were no side effects due to exposure of the axillary nerve. Level of evidence III, Retrospective Study. ATHA EDITORA 2019-05-30 2019 /pmc/articles/PMC6699393/ /pubmed/31452616 http://dx.doi.org/10.1590/1413-785220192703218226 Text en https://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Mouraria, Guilherme Grisi Zoppi, Américo Kikuta, Fernando Kenji Moratelli, Lucas Silveira, Paulo Pedroso Etchebehere, Maurício PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH |
title | PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH |
title_full | PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH |
title_fullStr | PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH |
title_full_unstemmed | PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH |
title_short | PROXIMAL HUMERAL FRACTURES TREATED WITH OSTEOSYNTHESIS USING THE ANTEROLATERAL APPROACH |
title_sort | proximal humeral fractures treated with osteosynthesis using the anterolateral approach |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6699393/ https://www.ncbi.nlm.nih.gov/pubmed/31452616 http://dx.doi.org/10.1590/1413-785220192703218226 |
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