DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20164161

Study of operative management of proximal humerus fracture treated with locking plates

Bhavik Y. Dalal, Dipalkumar V. Rathod, Raghav Suthar, Harshal Damor

Abstract


Background: This study was undertaken to evaluate the efficacy of Philos plate and to specifically study the clinical outcome of the patient treated with Philos plate for proximal humerus fracture on the radiological head shaft angle basis.

Methods: 40 cases of proximal humerus fracture fixed by using Philos plate were reviewed.

Results: Average constant shoulder score as Neer type-3 fracture is 83.8% and for type- 4 part fracture is 86%. Average radiological union was seen at 10.2 weeks. There was no major difference in clinical and radiological union.

Conclusions: Good functional outcome with Philos plate irrespective of fracture type was obtained.


Keywords


Locking plates, Proximal humerus fracture, Philos

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References


Geiger EV, Maier M, Kelm A, Wutzler S, Seebach C, Marzi I. Functional outcome and complications following PHILOS plate fi xation in proximal humeral fractures. Acta Orthop Traumatol Turc. 2010;44(1):1-6.

Baron JA, Barrett JA, Karagas MR. The epidemiology of peripheral fractures. Bone. 1996;18(3):209-13.

Lanting B, MacDermid J, Drosdowech D, Faber KJ. Proximal humeral fractures: a systematic review of treatment modalities. J Shoulder Elbow Surg. 2008;17(1):42-54.

Lee SH, Dargent-Molina P, Breart G. Risk factors for fractures of the proximal humerus: results from the EPIDOS prospective study. J Bone Miner Res. 2002;17(5):817-25.

Nguyen TV, Center JR, Sambrook PN, Eisman JA. Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study. Am J Epidemiol. 2001;153(6):587-95.

Nho SJ, Brophy RH, Barker JU, Cornell CN, MacGillivray JD. Innovations in the management of displaced proximal humerus fractures. J Am Acad Orthop Surg. 2007;15(1):12-26.

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

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.

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.

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.

Robinson CM, Page RS, Hill RM, Sanders DL, Court-Brown CM, Wakefield AE. Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am. 2003;85(7):1215-23.

Sadowski C, Riand N, Stern R, Hoffmeyer P. Fixation of fractures of the proximal humerus with the Plant Tan Humerus Fixator Plate: early experience with a new implant. J Shoulder Elbow Surg. 2003;12(2):148-51.

Björkenheim JM, Pajarinen J, Savolainen V. Internal fixation of proximal humeral fractures with a locking compression plate: a retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand. 2004;75(6):741-5.

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.

Vallier HA. Treatment of proximal humerus fractures. J Orthop Trauma. 2007;21(7):46976.

Constant CR, Murley AH. A Clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160-4.

Lill H, Hepp P, Rose T, Konig K, Josten C. The angle stable locking proximal humerus-plate (LPHP) for proximal humeral fractures using a small anterior-lateral-deltoid-splitting-approach technique and first results. Zentralbl Chir. 2004;129(1):43-8.

Hall JA, Phieffer LS, McKee MD. Humeral shaft split fracture around proximal humeral locking plates: a report of two cases. J Orthop Trauma. 2006;20(10):710-4.

Siffri PC, Peindl RD, Coley ER, Norton J, Connor PM, Kellam JF. Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture: comparison using cadaveric and synthetic humeri. J Orthop Trauma. 2006;20(8):547-54.

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. 2007;22(2):176-82.

Walsh S, Reindl R, Harvey E, Berry G, Beckman L, Steffen T. Biomechanical comparison of a unique locking plate versus a standard plate for internal fixation of proximal humerus fractures in a cadaveric model. Clin Biomech. 2006;21(10):1027-31.

Papadopoulos P, Karataglis D, Stavridis SI, Petsatodis G, Christodoulou A. Midterm results of internal fixation of proximal humeral fractures with the PHILOS plate. Injury. 2009;40(12):1292-6.

Gardner MJ, Weil Y, Barker JU, Kelly BT, Helfet DL, Lorich DG. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007;21(3):185-91.

Wijgman AJ, Roolker W, Patt TW, Raaymakers EL, Marti RK. Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus. J Bone Joint Surg Am. 2002;84(11):1919-25.

Gardner MJ, Voos JE, Wanich T, Helfet DL, Lorich DG. Vascular implications of minimally invasive plating of proximal humerus fractures. J Orthop Trauma. 2006;20(9):602-7.

Liew AS, Johnson JA, Patterson SD, King GJ, Chess DG. Effect of screw placement on fi xation in the humeral head. J Shoulder Elbow Surg. 2000;9(5):423-6.

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

Egol KA, Ong CC, Walsh M, Jazrawi LM, Tejwani NC, Zuckerman JD. Early complications in proximal humerus fractures (OTA Types 11) treated with locked plates. J Orthop Trauma. 2008;22(3):159-64.

Owsley KC, Gorczyca JT. Fracture displacement and screw cutout after open reduction and locked plate fixation of proximal humeral fractures [corrected]. J Bone Joint Surg Am. 2008;90(2):233-40.

Agudelo J, Schürmann M, Stahel P, Helwig P, Morgan SJ, Zechel W, et al. Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. J Orthop Trauma. 2007;21(10):676-81.

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.

Hepp P, Theopold J, Voigt C, Engel T, Josten C, Lill H. The surgical approach for locking plate osteosynthesis of displaced proximal humeral fractures influences the functional outcome. J Shoulder Elbow Surg. 2008;17(1):21-8.

Esser RD. Treatment of three- and four-part fractures of the proximal humerus with a modifi ed cloverleaf plate. J Orthop Trauma. 1994;8(1):15-22.

Lee CK, Hansen HR. Post-traumatic avascular necrosis of the humeral head in displaced proximal humeral fractures. J Trauma. 1981;21(9):788-91.

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.

Hawkins RJ, Bell RH, Gurr K. The three-part fracture of the proximal part of the humerus. Operative treatment. J Bone Joint Surg Am. 1986;68(9):1410-4.

Bastian JD, Hertel R. Initial post-fracture humeral head ischemia does not predict development of necrosis. J Shoulder Elbow Surg. 2008;17(1):2-8.

Gerber C, Hersche O, Berberat C. The clinical relevance of post-traumatic avascular necrosis of the humeral head. J Shoulder Elbow Surg. 1998;7(6):586-90.

Solberg BD, Moon CN, Franco DP, Paiement GD. Locked plating of 3- and 4-part proximal humerus fractures in older patients: the effect of initial fracture pattern on outcome. J Orthop Trauma. 2009;23(2):113-9.

Hertel R, Hempfing A, Stiehler M. Predictors of humeral head ischemia after intracapsular fracture of the proximal humerus. J Shoulder Elbow Surg. 2004;13(4):427-33.

Kettler M, Biberthaler P, Braunstein V, Zeiler C, Kroetz M, Mutschler W. Treatment of proximal humeral fractures with the PHILOS angular stable plate. Presentation of 225 cases of dislocated fractures. Unfallchirurg. 2006;109(12):1032-40.