Comparative Evaluation of Patient-reported Outcomes in Proximal Humeral Fracture: Deltoid-Splitting versus Deltopectoral Approaches.

Background: Proximal humeral fractures (PHF) are common orthopedic injuries often associated with osteoporosis. Surgical approaches for PHF fixation, such as the deltopectoral and deltoid-splitting methods, have been a subject of debate. Additionally, patient satisfaction with these approaches has not been extensively studied among Iranian patients.

Materials And Methods: A cross-sectional study was conducted on patients treated for PHF at a referral orthopedic center in Tehran, Iran, from 2019 to 2021. Two surgical techniques, deltopectoral and deltoid-splitting, were compared. Patient-reported outcomes in terms of patient satisfaction, including quality of life (SF-36), pain relief (VAS score), and shoulder function (Constant score), were assessed at six- and 12-month intervals postsurgery. Statistical analyses were performed to determine the differences between the two approaches.

Results: Among 148 patients, the majority were male (72.3%), 104 (70.3%) and 44 (29.7%) of patients were operated by deltopectoral and deltoid-splitting approaches, respectively. Patients' quality of life scored higher in the deltoid-splitting group both in six and one year following the surgical procedure; however, the observed differences did not reach statistical significance ( values 0.121 and 0.736, respectively). While there were slight variations in shoulder function and pain relief between the surgical approaches, none of these differences reached statistical significance.

Conclusion: This study suggests that both deltopectoral and deltoid-splitting surgical approaches for PHF treatment offer comparable patient satisfaction and functional outcomes. Surgeons can consider their expertise and patient-specific factors when selecting the appropriate approach for PHF fixation.