Early Outcomes of Proximal Humerus Fractures Treated With Proximal Humerus Locking Plate Fixation Using the Deltoid-Split Approach

Introduction The deltopectoral approach is the workhorse approach used for plating of proximal humerus fractures. However, the less invasive and less commonly used deltoid-split approach has shown comparable outcomes in selected cases. Literature on its functional outcomes and complications remains limited, especially in the Indian subcontinent. This study evaluates the results of patients with proximal humeral fractures managed by open reduction and internal fixation (ORIF) with plating using proximal humerus locking plates (PHLPs) performed through the deltoid-split approach. Materials and methods This prospective case series was conducted in a tertiary hospital after ethical clearance. Twenty-one patients meeting the inclusion and exclusion criteria underwent ORIF using the deltoid-split approach. Minimum follow-up was at least one year. Functional outcomes were assessed using QuickDASH (Disabilities of Arm, Shoulder, and Hand) and VAS (Visual Analog Scale) scores. Complications such as surgical site infection, wound complications, nerve injury, implant impingement, or failure were recorded. Results At 3, 6, and 12 months, mean QuickDASH scores were 24.41, 12.37, and 3.90, and VAS scores were 5.0, 2.94, and 0.2, respectively. All fractures united by nine months. No surgical site infection, wound dehiscence, varus collapse, or implant failure occurred. One case each of implant impingement and malreduction, and two cases of axillary nerve palsy were noted. Conclusion Surgical fixation of proximal humerus fractures using the deltoid-split approach provides good recovery with minimal complications. The outcomes are comparable with those achieved using the deltopectoral approach in the literature. It offers tuberosity access with less soft tissue dissection. Surgeons should be accustomed to both approaches and choose the approach according to the fracture configuration.