Use of proximal humerus internal locking system plate in proximal humerus fractures and its relation with the functional outcome

Prasanna Kumar G. S.; Akash V. Mane; Amit Kumar Yadav; Abhishek Harsoor; Jithsen Manna

doi:10.18203/issn.2455-4510.IntJResOrthop20195799

Authors

Prasanna Kumar G. S. Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Akash V. Mane Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Amit Kumar Yadav Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Abhishek Harsoor Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India
Jithsen Manna Department of Orthopaedics, Grant Government Medical College and Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20195799

Keywords:

Proximal humerus fractures, PHILOS plate, Internal fixation, Functional outcome

Abstract

Background: Proximal humerus fractures are the fractures occurs at or proximal to the surgical neck of the humerus, which accounts for 7% of all fractures and 80% of all humeral fractures. Now a days most of these fractures are managed with internal fixation because of better availability of anatomical plates. The aim was to assess the functional outcome and complications of proximal humerus fractures treated with proximal humerus internal locking system (PHILOS).

Methods: This is a prospective study of 30 patients with two, three, and four parts proximal humerus fractures treated with proximal humerus internal locking sysyem from 2016 to 2018 with 25 to 80 years of age in a tertiary care hospital. Functional outcome is assessed by using constant murley shoulder scoring system.

Results: Functional outcome as per constant score, 10 patients (33%) got excellent outcome, 06 patients (20%) got very good outcome, 07 patients got (23%) good outcome, 05 patients got (17%) fair outcome and 02 patients got (07%) poor outcome. Complications observed were superficial infections, implant failure and axillary nerve neuropraxia.

Conclusions: Open reduction and internal fixation by using PHILOS is the ideal method in treating displaced proximal humerus fractures mainly in two and three part proximal humerus fractures which provides stable fixation and less complications.

Metrics

Metrics Loading ...

References

Nordqvist A, Petersson CJ. Incidence and causes of shoulder girdle injuries in an urban population. J Shoulder Elbow Surg. 1995;4(2):107-12.

Bell JE, Leung BC, Spratt KF, Koval KJ, Weinstein JD, Goodman DC, et al. Trends and variation in incidence, surgical treatment, and repeat surgery of proximal humeral fractures in the elderly. J Bone Joint Surg Am. 2011;93(2):121.

Lind T, Krøner K, Jensen J. The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg. 1989;108(5):285-7.

Horak J, Nilsson BE. Epidemiology of fracture of the upper end of the humerus. Clin Orthop Related Res. 1975;112:250-3.

Clinton J, Franta A, Polissar NL, Neradilek B, Mounce D, Fink HA, et al. Proximal humeral fracture as a risk factor for subsequent hip fractures. J Bone Joint Surg Br. 2009;91(3):503.

Court-Brown CM, Garg A, McQueen MM. The translated two-part fracture of the proximal humerus: epidemiolo-gy and outcome in the older patient. J Bone Joint Surg Br. 2001;83(6):799-804.

Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta orthopaedica Scandinavica. 2001;72(4):365-71.

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

Robinson CM, Page RS. Severely impacted valgus proximal humeral fractures: Results of operative treatment. J Bone Joint Surg Am. 2003;85:1647-55.

Wanner GA, Wanner-Schmid E, Romero J, Hersche O, von Smekal A, Trentz O et al. Internal fixation of dis-placed proximal humeral fractures with two one-third tubular plates. J Trauma. 2003;54:536-44.

Park MC, Murthi AM, Roth NS, Blaine TA, Levine WN, Bigliani LU. Two-part and three-part fractures of the proximal humerus treated with suture fixation. J Orthop Trauma. 2003;17:319-25.

Vijayvargiya M, Pathak A, Gaur S. Outcome Analysis of Locking Plate Fixation in Proximal Humerus Fracture. J Clin Diagn Res. 2016;10(8):RC01-5.

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

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.

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.

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