Outcome of locking plate fixation for proximal humerus fractures

Abstract

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate functional outcome of open reduction and internal fixation with proximal humeral internal locking system (PHILOS) plate for proximal humerus fractures.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> We reviewed 30 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2010 to 2015. There were 23 men and7 women with a mean age of 36 years (range 20-64).There were 22 patients in the age group of <60 years and 8 patients in the age group of >60 years. According to Neer classification system, 12, 11 and 4 patients had2-part, 3-part, and 4-part fractures, respectively and 2 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma center. Functional evaluation of the shoulder at final follow-up was done using Neer’s Evaluation Criteria.</span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> The mean follow-up period was 20 months (range 14-40 months). All fractures united clinically and radio logically. The mean time for radiological union was 13.2 weeks (range 9-26 weeks).At the final follow-up the mean Neer’s Evaluation Criteria was 90 (range 76-100). The results were excellent in 17patients, Satisfactory in 8 patients, Unsatisfactory in 4 patients and Failure in 1 patient. During the follow-up, 3 cases of varus malunion, 1 case of failure of fixation were noted. No cases of AVN, hardware failure, locking screw loosening, infection or nonunion were noted.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> PHILOS provides stable fixation in proximal humerus fractures. In order to prevent the complications like avascular necrosis, knowledge of anatomy and vascular supply of head of humerus and good surgical dissection to preserve vascularity of humeral head is important.</span></p>

Effectiveness and Short Term Functional Results of Surgical Treatment with Locking Plate in Proximal Humerus Fractures

“…Edwards et al (22) reported that locking plate is highly superior over proximal humerus nailing in terms of both varus bending and torsional stability. In a study by Rohra et al (23) reporting the results of locking plate method for proximal humerus plate, overall complication rate was indicated as 20 percent. In our study also overall complication rate was found as 23.5 percent.…”

A study of functional outcome of displaced proximal humerus fracture treated with philos plating

“…In young patients high energy trauma is most common cause, in elderly patients -trivial fall (due to osteoporosis) is most common cause [7] . Different techniques like closed reduction with K-wire, open reduction with fixation with bone sutures, Multi lock nail, Reverse shoulder replacement, Polaris nail have been developed [8] . Complications from above methods like cutout/backout of screws, avn, nail migration, rotator cuff impingment are present [9] .…”