Functional outcome of proximal humerus fractures treated with open reduction and internal fixation using proximal humerus locking plate: a prospective hospital-based study

Rudra Sardar; Rajiv Roy; Arshad Ahmed; Dibakar Mallick; Rajkumar Poria

doi:10.18203/issn.2455-4510.IntJResOrthop20261212

Authors

Rudra Sardar Department of Orthopaedics, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
Rajiv Roy Department of Orthopaedics, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
Arshad Ahmed Department of Orthopaedics, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India
Dibakar Mallick
Rajkumar Poria Department of Orthopaedics, Calcutta National Medical College and Hospital, Kolkata, West Bengal, India

DOI:

https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20261212

Keywords:

Proximal humerus fracture, PHILOS plate, Constant-Murley score

Abstract

Background: Proximal humerus fractures account for 4-6% of all fractures and may result in significant functional impairment when displaced and inadequately treated.¹ Locking plate fixation offers angular stability and improved fixation, particularly in osteoporotic bone.^2,3

Methods: This prospective hospital-based study was conducted from June 2023 to July 2024. Thirty patients aged 18–65 years with acute displaced Neer two-part and three-part proximal humerus fractures were treated with open reduction and internal fixation using proximal humerus locking plates through a deltopectoral approach. Functional outcome was assessed using the Constant-Murley score and DASH score. Radiological union and complications were documented. Statistical analysis was performed using chi-square tests.

Results: The mean age was 44 years, with female predominance (60%). Two-part fractures constituted 60% and three-part fractures 40%. Radiological union was achieved in all cases. Functional outcomes were excellent in 20%, good in 50%, moderate in 20%, and poor in 10% of patients. Early surgery (≤5 days) and two-part fractures were significantly associated with better outcomes (p<0.05). Late complications such as stiffness and malunion negatively influenced outcomes (p=0.002).

Conclusions: Open reduction and internal fixation using proximal humerus locking plates provides reliable union and satisfactory functional outcomes in displaced proximal humerus fractures when performed early and with appropriate patient selection.

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