Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Spross, Christian; Platz, Andreas; Erschbamer, Matthias; Lattmann, Thomas; Dietrich, Michael

doi:10.1007/s11999-011-2207-1

Cited by 66 publications

(49 citation statements)

References 26 publications

(44 reference statements)

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“…This result is comparable to the one prospective study in which the mean Constant score for 4-part fractures was significantly inferior to other types [13] . The results of two studies indicated an advantage in functional outcomes favoring shoulder hemiarthroplasty compared with ORIF with a locking plate in 4-part fracture [24,25] . These results are expected as these fractures are more complex and open reduction and internal fixation is tougher.…”

Section: Discussionmentioning

confidence: 99%

Philos Plate in Proximal Humerus Fracture–Its Functional Outcome and Complications

Bansal

Sohal

Bhoparai

2015

International Journal of Orthopaedics

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AIM:Technique for the fixation of two, three, and four part proximal humerus fractures has rapidly shifted towards the use of locking plates. The objective of this prospective study was to evaluate functional outcome and complications of proximal humeral fractures managed with proximal humerus internal locking system (PHILOS). METHODS: 16 men and 9 women aged 19 to 82 (mean, 49.24) with an acute proximal humerus fracture were treated with PHILOS plate by using deltopectoral approach. Outcome measurements included Constant score, complications, and radiographic assessment. RESULTS: 11 patients had 2-part fractures, 11 patients had 3-part fractures, and 3 patients had 4-part fractures. After 6 month follow up, a mean Constant score 57.4 was achieved. Outcomes were excellent in 16%, good in 44%, fair in 16% while poor in 24%. The Constant score was poorer for Neer type IV fractures as compared to other types. The most frequently occurring complications in our patients were malreduction 20%, screw perforation 16%, infection 12%, avascular necrosis 8%, frozen shoulder 8%, impingement 4% and plate pull out 4%. CONCLUSION: Fixation of proximal humerus fractures with proximal humerus locking plates is associated with satisfactory functional outcomes in 2-part and 3-part fracture. The incidence of complications and subsequent re-operation is relatively high. Advanced surgical skills and surgeon's experience are considered to be more critical for successful operative treatment.

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Section: Discussionmentioning

confidence: 99%

Philos Plate in Proximal Humerus Fracture–Its Functional Outcome and Complications

Bansal

Sohal

Bhoparai

2015

International Journal of Orthopaedics

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“…Furthermore, for these types of complex fractures, both nonoperative treatment and fragment fixation have a high risk of nonunion, malunion or osteonecrosis [4][5][6][7]. With recent advancement in technique and implants for the treatment of fracture, arthroplasty is therefore generally considered as the best choice for these complex fractures and better outcomes than nonoperative or fragment fixation have been observed.…”

Section: Introductionmentioning

confidence: 99%

Meta-analysis suggests that reverse shoulder arthroplasty in proximal humerus fractures is a better option than hemiarthroplasty in the elderly

Wang

Zhu

Zhang

et al. 2015

International Orthopaedics (SICOT)

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“…Perforation of head screws seems to be the most frequent implant-specific complication, with rate of up to 67%. 33) In the current study, there were two cases of screw perforation. In one case, due to a persistent presence of the pain, the removal of plate and screw was performed following the bone union.…”

Section: Discussionmentioning

confidence: 65%

Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates

Rhee¹,

Cho²,

Won³

et al. 2014

Clin Shoulder Elbow

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Background: Indirect reduction technique offers a valid option in the treatment of proximal humerus fracture. The purpose of this study is to evaluate the functional outcome and the complication rate after indirect reduction and internal fixation of unstable proximal humeral fractures with use of a locking plate. Methods: Twenty four patients with acute proximal humerus fracture were managed with indirect reduction and internal fixation with a locking plate. The mean follow-up period was 15.5 months. Results:The anatomical reduction of the medial cortex buttress was seen in 16 patients (66%) of the Group A and the non-anatomical reduction was seen in 8 patients (33%) of the Group B. Mean union time was 3.2 ± 1.9 months; it was 2.2 ± 0.6 months in the Group A and 5.3 ± 2.2 months in the Group B (p < 0.05). In our series, there were 6 cases of complications and these include 2 cases of varus malunion, 2 cases of shoulder stiffness, 1 case of heterotrophic ossification, 2 cases of screw perforation and 1 case of impingement. Conclusions: We conclude from our studies that indirect reduction and internal fixation using locking plate for acute proximal humerus fracture can give good results with bony union and predictable good overall functional outcome. If the medial cortex buttress is well maintained, a better anatomical reduction would be achieved, the union would be prompted, the pain would be further reduced and the range of the motion would be recovered more promptly. (Clin Shoulder Elb 2014;17(1):2-9)

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Surgical Treatment of Neer Group VI Proximal Humeral Fractures: Retrospective Comparison of PHILOS® and Hemiarthroplasty

Abstract: Background Neer Group VI proximal humeral fractures often are related to persistent disability despite surgical treatment. We retrospectively compared the outcome after open reduction and internal fixation with the PHILOS

Cited by 66 publications

References 26 publications

Philos Plate in Proximal Humerus Fracture–Its Functional Outcome and Complications

Philos Plate in Proximal Humerus Fracture–Its Functional Outcome and Complications

Meta-analysis suggests that reverse shoulder arthroplasty in proximal humerus fractures is a better option than hemiarthroplasty in the elderly

Indirect Reduction Technique in Proximal Humeral Fractures Stabilized by Locking Plates

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