Deltopectoral vs deltoid split approach for proximal humerus fractures treated with locking plate: Our experience

Table 1 Baseline characteristics and surgical parameters, n (%)

Variable	Deltoid split	Deltopectoral	P value
Number of patients	70	50	-
Female	40 (57.1)	28 (56.0)	0.89
Male	30 (42.9)	22 (44.0)	0.89
Mean age (years)	56.0 ± 8.3	56.5 ± 7.9	0.76
Fracture type (Neer II/III/IV)	37/21/12	22/15/13	0.58
Side (right/Left)	38/32	27/23	0.97
Incision length (cm)	10.0 ± 1.2	13.0 ± 1.5	< 0.001
Operative time (minutes)	68.5 ± 10.3	70.2 ± 9.7	0.45
Follow-up duration (months)	14.6 ± 2.8	14.3 ± 2.7	0.65

Table 2 Summary of study design, groups, and variables

Parameter	Description
Study design	Multicenter retrospective cohort study
Study period	January 2023–December 2023
Total patients	120
Surgical approaches	Deltoid split (n = 70), deltopectoral (n = 50)
Inclusion criteria	Age > 18, Neer type II–IV, closed fracture, open reduction and internal fixation, 12-month follow-up
Exclusion criteria	Open/pathological fractures, prior surgery, incomplete data, polytrauma
Implant type	Anatomical locking plate
Outcomes measured	Constant-Murley, Quick-Disabilities in Arm, Shoulder, and Hand questionnaire, Numeric Rating Scale, Short Form Health Survey-12v2
Radiographic evaluation	Head-shaft angle, calcar restoration, complications
Statistical analysis	t-test, Mann–Whitney U, χ2, Fisher’s exact; P < 0.05

Table 3 Patient distribution by surgical approach

Group	Number of patients	Percentage
Deltoid split	70	58.3
Deltopectoral	50	41.7

Table 4 Fracture types according to Neer classification

Group	Neer II	Neer III	Neer IV
Deltoid split	37	21	12
Deltopectoral	22	15	13

Table 5 Statistical comparison at 3-month follow-up

Parameter	Deltoid split (mean ± SD)	Deltopectoral (mean ± SD)	P value
Numeric Rating Scale Score	3.1 ± 1.2	5.9 ± 1.3	< 0.001
Quick-Disabilities in Arm, Shoulder, and Hand questionnaire	25.4 ± 7.8	37.1 ± 6.9	< 0.001
Short Form Health Survey-12v2	32.6 ± 6.3	40.3 ± 5.4	0.003
Constant-Murley	68.2 ± 8.1	50.5 ± 9.4	0.002

Table 6 Clinical outcomes at follow-up

Time point	Numeric Rating Scale (DS/DP)	Quick-Disabilities in Arm, Shoulder, and Hand questionnaire (DS/DP)	Short Form Health Survey-12v2 (DS/DP)	Constant-Murley (DS/DP)
1 month	6/9	45/48	47/52	39/30
3 months	3/6	25/37	32/40	68/50
6+ months	1/1	13/14	16/15	93/91

DP: Deltopectoral; DS: Deltoid split.

Table 7 Postoperative complications

Complication	Deltoid split (n)	Deltopectoral (n)
Superficial wound infection	1	2
Deep infection	0	1
Loss of reduction	1	0
Avascular necrosis	0	2
Screw cut-out	0	2