PHILOS Plate Osteosynthesis in Metaphyseal Fractures of the Distal Humerus through an Anterolateral Approach

Abstract

Background: We described a surgical method for osteosynthesis and reported the resultant strength after application of a PHILOS plate through the anterolateral approach for the treatment of fractures of the distal humerus. Methods: Between February 2010 and March 2012, open reduction and internal fixation operations with the PHILOS plate for treatment of fracture of the distal humerus were performed on a total of nine patients (five men, four women). The mean age was 40.8 years (range, 24-50 years), and the average follow-up period was 9.1 months (range, 6-15 months). Clinical evaluations were performed 6 months after the operation. Clinical assessment included determination of the range of motion of the elbow, the Mayo and Oxford elbow scores, and any postoperative complications. Results: Fracture union was noted in all patients, with an average period of 12.4 weeks. The average Mayo elbow and Oxford elbow scores were 87.2 (of a total of 100) and 43.3 (of a total of 48), respectively. For the postoperative range of motion of the elbow, all patients showed complete recovery to the preoperative range of motion. No other conditions, such as neurolepsis, plate breakage, or rotational deformity, were observed. Conclusions: Open reduction and internal fixation of distal humerus fractures with a PHILOS plating system via anterolateral approach can be effective. A high rate of union with good outcomes can be assumed. (Clin Shoulder Elbow 2015;18(3):128-132)

Biomechanical performance evaluation of a modified proximal humerus locking plate for distal humerus shaft fracture using finite element analysis

“…In line with our findings, retrospective studies of the PHILOS alone or in comparison with the EADHP have shown satisfactory clinical and radiologic outcomes 6 , 22 , 28 . In a biomechanical study using cadavers, Lim et al 18 reported that anterior plating with a modified PHILOS showed a fixation and biomechanical performance comparable to those of posterior plating with the EADHP.…”

“…As a result, we determined the fixation range and state of the PHILOS. In previous studies, anterior plating was performed with the modified PHILOS 22 , 28 , and a comparison was made between posterior plating with the EADHP and anterior plating with the modified PHILOS 6 . Biomechanical study using cadavers to compare posterior plating with the EADHP and anterior plating with the modified PHILOS have also been conducted 18 .…”

Anatomic fit of precontoured extra-articular distal humeral locking plates: a cadaveric study

“…This locking plate does not use the posterolateral column of the distal humerus and seems to be less affected by protrusion; however, whether the biomechanical properties of the plate are comparable to conventional EADHPs should be investigated. As another alternative, a locking compression plate used for the proximal humerus was suggested via an anterolateral approach [19,20]. A previous biomechanical study showed that modified use of a proximal humeral locking plate has comparable mechanical stability com-Fig.…”

EDITORIAL : Plating Other than Where They Are Designed to Be Placed

“…But sometimes they are being used other than where they are supposed to be placed. The report 'PHILOS Plate Osteosynthesis in Metaphyseal Fractures of the Distal Humerus through an Anterolateral Approach' by Park et al 1) is one of the good examples, where the authors placed PHILOS plates on distal humerus fractures, which was designed originally for proximal humerus fractures. The authors claim that the wellconformed anatomical framework between the plate and the anterior surface of distal humerus make it possible to fix the fracture suitably.…”