ORIGINAL RESEARCH article
Front. Surg.
Sec. Orthopedic Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1541921
This article is part of the Research TopicDiagnosis and Treatment of Osteoporotic Fractures: Advances, Challenges, and Future PerspectivesView all 4 articles
Comparative Efficacy of the Modified Minimally Invasive "Parachute Technique" Versus the Intermuscular Gap Approach in Proximal Humeral Fracture Management: A Prospective Study
Provisionally accepted
- 1Wuxi Traditional Chinese Medicine Hospital, Wuxi, Jiangsu Province, China
- 2Changzhou Hospital Affiliated to Nanjing University of Chinese Medicine, Changzhou, China
- 3Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan Province, China
- 4Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan Province, China
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Background: Proximal humeral fractures (PHFs) are common in elderly individuals, often resulting from osteoporosis and falls. Surgical intervention is required for displaced fractures to restore shoulder function. This study compares the Modified Minimally Invasive Parachute Technique and the Intermuscular Gap Approach in the management of displaced PHFs. Objective: To compare clinical outcomes, including surgical efficiency, complication rates, functional recovery, and radiographic healing, between the two surgical techniques. Methods: A total of 40 patients aged 60 or older with displaced two-or three-part PHFs were randomized into two groups (n=20 per group). Primary outcomes included surgical duration, intraoperative blood loss, and postoperative drainage. Secondary outcomes included pain relief (Visual Analog Scale), shoulder function (Neer Shoulder Score), and fracture healing (Radiographic Union Scoring System, RUST).The Parachute Technique group had significantly shorter operation times (97.25 ± 16.09 minutes vs. 119.75 ± 17.13 minutes, p < 0.001) and lower blood loss (99.00 ± 25.06 mL vs. 207.50 ± 44.47 mL, p < 0.001). Postoperative drainage was also significantly reduced in the Parachute Technique group (81.50 ± 13.48 mL vs. 119.00 ± 21.01 mL, p < 0.001). Functional recovery, assessed by the Neer Shoulder Score, was significantly better in the Parachute Technique group at 3, 6, and 12 months (p < 0.001). At 6 months, radiographic healing showed a trend towards better union in the Parachute Technique group (9.00 ± 0.73 vs. 8.60 ± 0.59, p = 0.072).Complication rates were similar between the two groups (p = 0.68).The Modified Minimally Invasive Parachute Technique offers superior surgical efficiency, reduced blood loss, and better functional outcomes compared to the Intermuscular Gap Approach, making it a favorable option for elderly patients with displaced PHFs.
Keywords: Proximal humeral fractures, minimally invasive surgery, Parachute technique, intermuscular gap approach, functional recovery
Received: 09 Dec 2024; Accepted: 16 May 2025.
Copyright: © 2025 Wei, Li, Chen, Yi, Zhao, Tian and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jian Wei Wang, Wuxi Traditional Chinese Medicine Hospital, Wuxi, Jiangsu Province, China
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