• Li Zhao, Peng Yang, Lei Zhu, and Ai-Min Chen.
• Department of Orthopedic Trauma Surgery, Changzheng Hospital, the Second Military Medical University, 415 Feng Yang Rd., Huang Pu district, Shanghai, 200003, China.
• Bmc Musculoskel Dis. 2017 May 12; 18 (1): 187.

BackgroundCurrent treatments for proximal humeral fractures include conservative treatment, conventional open reduction internal fixation (ORIF) and MIPPO through deltoid-splitting approach. The aim of this study was to evaluate the clinical outcome of MIPPO versus ORIF via the deltoid-pectoralis approach in elderly patients with proximal humeral fractures.MethodsThirty-six patients with proximal humeral fractures were enrolled in this study. Following the randomized block and single-blinded principle, the patients were assigned to two groups and treated with either conventional ORIF or MIPPO, both through the deltoid-pectoralis approach. Surgical outcomes were evaluated by the NEER score, Constant-Murley score, blood loss, length of operation, radiological imaging and clinical examination. The patients were followed up for 4-24 (mean 10) months.ResultsAccording to Constant-Murley score, the surgical outcome was excellent in 14 cases, satisfactory in 2 cases and unsatisfactory in one case in MIPPO group versus 10, 5 and 4 in conventional ORIF group. MIPPO was significantly advantageous over conventional ORIF in terms of NEER score, Constant-Murley, length of operation and intraoperative blood loss. In addition, MIPPO was also more advantageous in several indexes in patients with BMI > 26.0 and NEER type III fracture.ConclusionThe results of our study have demonstrated that MIPPO through the deltoid-pectoralis approach is an effective alternative for the treatment of proximal humeral fractures in elderly patients.Trial RegistrationThe trial registration number (TRN): ChiCTR-INR-17011098 (retrospectively registered at 2017-04-09).

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