Kovalchuk V. Optimization of surgical treatment of intraarticular proximal humeral fractures

The analysis and comparison of functional results dynamics of surgical treatment of 175 patients with intraarticular proximal humeral fractures by means of standard and minimally-invasive surgical technologies of osteosynthesis were performed using Constant and QuickDASH scores for each type of intraarticular fractures. The indication for minimally-invasive osteosynthesis with limited anterolateral surgical approach was defined and recommended for type C1 fractures with moderate displacement. The application of standard osteosynthesis was substantiated for type C2 fractures with marked displacement. The application of either osteosynthesis technology for type C3 fracture-dislocation do not result in satisfactory outcomes. The dependence of functional results on modified and unmodified factors was proved, as well as the definition and classification of postoperative complications for each type of intra-articular fractures. Based on analysis of obtained data, a differentiated approach for choosing the optimal tactic of surgical treatment of type C fractures was developed, depending on the severity and time of the injury.