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Abstract Objective To comapre the clinical outcomes of Neer Ⅱ and Ⅲ elderly osteoporotic proximal humerus fractures by deltoid approach and deltopectoral approach.Methods From January 2013 to January 2017，81 patients with Neer Ⅱ and Ⅲ elderly osteoporotic proximal humeral fractures were treated with proximal humerus locking plate.Among them，42 cases were treated with minimally invasive approach through deltoid under anterolateral acromion，including 12 males and 30 females with an average of (69.8±10.4)years old (61~81 y).39 cases were treated with traditional deltopectoral approach，17 males and 22 females with an average age of (68.7±12.6)years old (59~82 y).The clinical efficacy of two surgical approaches were evaluated by observing pre-and post-operative creatine kinase，fracture reduction quality，fracture healing time，shoulder muscle strength and function.Results Of the 81 patients，72 follow-up，including 38 minimal approach and 34 traditional approach The follow-up period was 12 to 58 months with an average of 35 months.There was no significant difference in the quality of the reduction and healing time between the two groups(P＞0.05)，In the muscle injury (creatine kinase)，shoulder muscle strength and shoulder function，the deltoid group was significantly better than the traditional deltopectoral group (P＜0.05).Conclusion Compared with the traditional deltopectoral approach，the treatment of Neer Ⅱ and Ⅲ elderly osteoporotic proximal humeral fractures through the deltoid approach has the advantages of less surgical trauma and quick postoperative recovery.The clinical effect is satisfactory and can be used as preferred treatment for Neer Ⅱ and Ⅲ elderly osteoporotic proximal humerus fractures.
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