Mujahid Jamil Khattak, Irfan Anwer, Muhammed Tabish Saleem, Ahmed Abdul Habib Khan, Mohammad Zohaib Nawaz Khan.
The functional outcome of direct lateral approach for fixation of proximal humeral fractures: a case series from a tertiary care hospital..
J Pak Med Assoc Jan ;69(12):1915-8.

Displaced proximal humeral fractures warrant surgical fixation for early rehabilitation and better functional outcome. These fractures are traditionally fixed by delto pectoral surgical approach. Direct lateral approach has recently gained interest as it involves less soft tissue dissection and is particularly helpful in certain fracture patterns. However, there have been concerns of axillary nerve damage with this approach. We report a case series of proximal humerus fractures fixed by direct lateral approach from our institution. All displaced Type 2 and 3 fractures were included in our study. Pathological and comminuted Type 4 fractures and fractures with ipsilateral clavicle or elbow fractures were excluded. Oxford Shoulder Score was done at regular intervals for assessment of functional outcome. We did not observe any axillary nerve damage in our case series and the outcomes of 70.5% of our patients were excellent while in 29.5% it was good. We recommend direct lateral approach for specific pattern of proximal humerus fractures.

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