Abstract
The anterolateral acromial approach leads to the proximal humerus, between the deltoid muscle fibers.
We report usefulness of this approach to fix proximal humeral fractures with Locking Humerus Spoon Plate [SYNTHES]. We treated 10 shoulders (2 men 8 women) from August 2004 to July 2005. The mean age was 66 years(range 47-79 years). All patients underwent operation by this approach. Active·passive ROM exercise started the day after operation. The patients obtained good ROM and scored a mean 88 points on the JOA shoulder score. All of the patients had bone union, but one developed humeral head necrosis after bone union.
The approach need not be detached from the muscle origin on the clavicle, which allows early active ROM exercise without immobilization. The patient can get good shoulder ROM. Wide surgical exposure may damage the tenuous remaining blood supply, but it does not damage the anterior potion of the shoulder, especially the anterior circumflex humeral artery. So it should decrease complications such as humeral head necrosis.
