A study of the functional assessment of the outcomes of proximal humerus fractures treated with the proximal humerus internal locking system

Vijay Yadav; Harshad Gujar; Ritesh Pathak

doi:10.18203/issn.2455-4510.IntJResOrthop20254101

Authors

Vijay Yadav Department of Orthopaedics, PCMC’s PG Institute and YCM Hospital, Pune, Maharashtra, India; Department of Orthopaedics, B.J. Government Medical College, Pune, Maharashtra, India https://orcid.org/0000-0002-6158-6493
Harshad Gujar Department of Orthopaedics, PCMC’s PG Institute and YCM Hospital, Pune, Maharashtra, India
Ritesh Pathak Department of Orthopaedics, PCMC’s PG Institute and YCM Hospital, Pune, Maharashtra, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20254101

Keywords:

Constant–Murley score, Functional outcome, Internal fixation, Proximal humerus fracture, PHILOS plate

Abstract

Background: Proximal humerus fractures are common in adults, particularly in elderly individuals with osteoporosis. Modern fixation systems such as the PHILOS (Proximal Humerus Internal Locking System) plate aim to improve stability, reduce complications and facilitate early mobilisation. To assess the functional outcomes of displaced proximal humerus fractures managed with PHILOS plating in a tertiary care hospital.

Methods: This prospective observational study included skeletally mature adults (>18 years) with displaced proximal humerus fractures who underwent open reduction and internal fixation using PHILOS plating between July 2020 and July 2021. Exclusion criteria included open fractures, undisplaced fractures, fracture–dislocations limited to tuberosity, neurovascular injury and medical unfitness. Follow-up at 2, 6, 8 and 12 weeks assessed radiological union and functional recovery using the Constant–Murley Score. Data analysis was performed using IBM SPSS Statistics for Windows, Version 26.0.

Results: Fifty–three patients were included with a mean age of 50 years and a male–to–female ratio of 4:1. Road traffic accidents accounted for 58.5% of injuries. Radiological union was confirmed in 96% by 12 weeks. Functional outcomes were good in 13 patients, moderate in 35 and poor in 5. Superficial wound infection occurred in 3 patients and implant failure in 1.

Conclusions: PHILOS plating provides stable fixation with predominantly moderate to good short-term functional outcomes and low complication rates in displaced proximal humerus fractures.

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References

Geiger EV, Maier M, Kelm A, Wutzler S, Seebach C, Marzi I. Functional outcome and complications following PHILOS plate fixation in proximal humeral fractures. Acta Orthop Traumatol Turc. 2010;44(1):1-6. DOI: https://doi.org/10.3944/AOTT.2010.2270

Lind T, Krøner K, Jensen J. The epidemiology of fractures of the proximal humerus. Arch Orthop Trauma Surg. 1989;108(5):285-7. DOI: https://doi.org/10.1007/BF00932316

Kannus P, Palvanen M, Niemi S, Parkkari J, Järvinen M, Vuori I. Osteoporotic fractures of the proximal humerus in elderly Finnish persons: sharp increase in 1970-1998 and alarming projections for the new millennium. Acta Orthop Scand. 2000;71(5):465-70. DOI: https://doi.org/10.1080/000164700317381144

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(5):319-25. DOI: https://doi.org/10.1097/00005131-200305000-00001

Ogiwara N, Aoki M, Okamura K, Fukushima S. Ender nailing for unstable surgical neck fractures of the humerus in elderly patients. Clin Orthop Relat Res. 1996;(330):173-80. DOI: https://doi.org/10.1097/00003086-199609000-00021

Resch H, Povacz P, Fröhlich R, Wambacher M. Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br. 1997;79(2):295-300. DOI: https://doi.org/10.1302/0301-620X.79B2.0790295

Kiliç B, Uysal M, Cinar BM, Ozkoç G, Demirörs H, Akpinar S. Proksimal humerus kiriklarin PHILOS plaği ile tedavisinde erken dönem sonuçlarimiz [Early results of treatment of proximal humerus fractures with the PHILOS locking plate. Acta Orthop Traumatol Turc. 2008;42(3):149-53. DOI: https://doi.org/10.3944/AOTT.2008.149

Nho SJ, Brophy RH, Barker JU, Cornell CN, MacGillivray JD. Management of proximal humeral fractures based on current literature. J Bone Joint Surg Am. 2007;89(3):44-58. DOI: https://doi.org/10.2106/JBJS.G.00648

Gerber C, Werner CM, Vienne P. Internal fixation of complex fractures of the proximal humerus. J Bone Joint Surg Br. 2004;86(6):848-55. DOI: https://doi.org/10.1302/0301-620X.86B6.14577

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(3):57. DOI: https://doi.org/10.4103/0973-6042.59971