Anterolateral acromial approach in locking plate fixation of proximal humerus fractures in elderly patients.

We describe our experience with a two-incision anterolateral acromial approach in locking plate ­ ­of ­proximal ­humeral ­fractures ­in ­older ­adults. ­ Mean ­time ­between ­injury ­and ­surgery ­was ­3.08 ­ ± ­ 1.24 ­ days. ­A ­proximal ­anterolateral ­transverse ­inci sion ­and ­a ­more ­distal ­longitudinal ­incision ­were ­used. ­ A ­locking ­plate ­was ­inserted ­along ­the ­lateral ­side ­of ­ the ­humerus ­from ­the ­proximal ­incision ­to ­the ­distal ­ fragment ­of ­the ­humerus. ­Mean ­operation ­time ­was ­ 62.37 ­ ± ­ 19.05 ­ minutes. ­ There ­ were ­ no ­ instances ­ of ­ ­ ­ nerve ­ paralysis ­ or ­ infection. ­ Postoperative ­ imaging ­results ­were ­satisfactory ­in ­all ­cases. ­Three ­ obese ­patients ­experienced ­fat ­liquefaction ­at ­the ­inci sion ­site. ­Mean ­total ­Neer ­score ­one ­year ­after ­surgery ­ was ­88.16 ­ ± ­ 5.05. ­We ­conclude ­that ­the ­two-incision ­ anterolateral ­acromial ­approach ­with ­use ­of ­locking ­ plates ­appears ­to ­be ­an ­effective ­means ­to ­treat ­proxi mal ­ humeral ­ fractures ­ in ­ older ­ adults.