DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20183673

Assessment of functional outcome of surgical management of proximal humerus fracture treated with PHILOS plate

Jairam D. Jagiasi, Mihir R. Patel, Sagar G. Daliya, Amol Bochare, Manan Vora

Abstract


Background: Proximal humeral fractures were treated conservatively in the past and often had compromised functional results. With the advancement of surgical techniques, these fractures, especially displaced, are now more often managed operatively; to meet the needs of the patient, provide early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of operative management of proximal humeral fractures with Philos plate fixation.

Methods: In this prospective study, 30 patients aged 19-75 years (mean age 47.1 years) with fractures of the proximal humerus, including two-, three-, and four-part fractures, were treated by open reduction internal fixation with Philos plating. Patients’ functional outcomes were evaluated based on subjective (35 points) and objective (65 points) parameters, as per the constant scoring system.

Results: Functional outcome based on the constant scoring system of the patient at 6 month follow-up were compared. Excellent results were seen in 12 patients (40%), 2 had very good results (6.66%), 9 patients were having good (30%) and 6 had fair (20%) functional outcome. One patient had poor functional results (3.33%). Avascular necrosis (AVN) of the humeral head was observed in one patients.

Conclusions: Philos plate fixation for proximal humeral fractures provides good stable fixation with good functional outcome and is a feasible option.

 


Keywords


Philos plating, Proximal humerus fractures, Shoulder fractures

Full Text:

PDF

References


Court Brown CM, Caesar B. Epidemiology of adult fractures: A review Injury. 2006;37:691-7.

Young TB, Wallace WA. Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus J. J Bone Joint Surg Br. 1985;67(3):373-7.

Rose SH, Melton LJ 3rd, Morrey BF, Ilstrup DM, Riggs BL. Epidemiological features of humeral fractures Clin Orthop. 1982:168:24-30.

Sahu RL. Philos Locking plates in proximal humerus fractures literature review. Internet J Health. 2010;11:1.

Aaron D, Shatsky J, Paredes JC. Proximal humeral fractures: internal fixation. J Bone Joint Surg Am. 2012;94(24):2280-8.

Murray IR, Amin AK, White TO, Robinson CM. Proximal humeral fractures: current concepts in classification, treatment and outcomes. J Bone Joint Surg Br. 2011;93(1):1-11.

Frangen TM, Müller EJ, Dudda M, Arens S, Muhr G, K€alicke T. Proximal humeral fractures in geriatric patients. Is the angle-stable plate osteosynthesis really a breakthrough? Acta Orthop Belg. 2007;73:571-9.

Björkenheim JM, Pajarinen J, Savolainen V. Internal fixation of proximal humeral fractures with locking compression plate: A retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand. 2004;75:741-5.

Flores S, Merk BR. Two-part surgical neck fractures of the proximal part of the humerus: A biomechanical evaluation of two fixation techniques. J Bone Joint Surg Am. 2006;88:2258-64.

Kristiansen B, Christensen SW. Plate fixation of proximal humeral fractures. Acta Orthop Scand. 1986;57:320-3.

Lever JP, Aksenov SA, Zdero R, Ahn H, McKee MD, Schemitsch EH. Biomechanical analysis of plate osteosynthesis systems for proximal humerus fractures. J Orthop Trauma. 2008;22:23 9.

Seide K, Triebe J, Faschingbauer M, Schulz AP, Püschel K, Mehrtens G, et al. Locked vs. unlocked plate osteosynthesis of the proximal humerus A biomechanical study. Clin Biomech (Bristol, Avon) 2007;22:176-82.

Koukakis A, Apostolou CD, Taneja T, Korres DS, Amini A. Fixation of proximal humerus fractures using the PHILOS plate: Early experience. Clin Orthop Relat Res. 2006;442:115-20.

Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R. A new locking plate for unstable fractures of the proximal humerus. Clin Orthop Relat Res. 2005;430:176-81.

Moonot P, Ashwood N, Hamlet M. Early results for treatment of three and four part fractures of the proximal humerus using the PHILOS plate system. J Bone Joint Surg Br. 2007;89:1206-9.

Thyagarajan DS, Haridas SJ, Jones D, Dent C, Evans R, Williams R. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures. Int J Shoulder Surg. 2009;3:57-62.

Aggarwal S, Bali K, Dhillon MS, Kumar V, Mootha AK. Displaced proximal humeral fractures: An Indian experience with locking plates. J Orthop Surg Res. 2010;5:60.

Egol KA, Ong CC, Walsh M, Jazrawi LM, Tejwani NC, Zuckerman JD. Early complication of proximal humerus fractures treated with locked plates. J Ortho Trauma. 2008;22:159-64.

Gerber C, Worner CM, Vienne P. Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg (Br). 2004;86(60):848-55.

Booker S, Alfahad N, Scott M, Gooding B, Wallace WA. Use of scoring systems for assessing and reporting the outcome results from shoulder surgery and arthroplasty. World J Orthop. 2015;6(2):244–51.

Rose PS, Adams CR, Torchia ME, Jacofsky DJ, Haidukewych GG, Steinmann SP. Locking plate fixation for proximal humeral fractures: initial results with a new implant. J Shoulder Elbow Surg. 2007;16(2):202-7.

Siwach R, Singh R, Rohilla RK, Kadian VS, Sangwan SS, Dhanda M. Internal fixation of proximal humeral fractures with locking proximal humeral plate (LPHP) in elderly patients with osteoporosis. J Orthop Traumatol. 2008;9(3):149–53.

Kilic B, Uysal M, Cinar BM,Ozkoç G, Demirörs H, Akpinar S. Early results of treatment of proximal humerus fractures with the PHILOS locking plate. Acta Orthop Traumatol Turc. 2008;42(3):149-53.

Korkmaz MF, Aksu N, Gogus A, Debre M, Kara AN, Işiklar ZU. The results of internal fixation of proximal humeral fractures with the PHILOS locking plate. Acta Orthop Traumatol Turc. 2008;42(2):97-105.