Functional outcome of PHILOS plate in proximal humerus fractures

Abstract

Introduction: Proximal humeral fractures (PHFs) are the seventh most frequent fractures in adults [1]. Proximal Humerus Fractures constitute about 4% of all fractures and 26% of all humerus fractures [2]. Management of three-part and four-part fractures is still a challenge owing to associated complications including osteoporosis, angulation, unstable reduction, varus collapse, screw back out etc. Aim of our study was to assess the functional outcome proximal humerus fractures (Neers classification 2 part, 3 part and 4 part) treated with PHILOS (Proximal humeral internal locking system).Methods: Our study was a prospective study conducted at our institution from October 2018 to December 2019. The study group consisted of 30 patients including 6 female patients and 24 male patients. The Proximal humerus fractures were classified using Neer’s classification system. Open reduction and internal fixation with a PHILOS plate was carried out on all the patients under general anesthesia. All patients underwent a similar post-operative physiotherapy. Functional parameters were assessed using Constant-Murley scoring system. Results: In our study, 14 (46.7%) cases showed Excellent outcomes, 9 (30%) showed good outcomes, 4 (13.3%) showed fair outcomes and 3 (10%) showed poor outcomes. The mean constant score was 78 in our study. Our study group had 7 (23.3%) cases of complications. The most common complication was varus malunion which was seen in 3 (10%) cases.Conclusion: PHILOS plate provides a high degree of angular and axial stability eliminating screw loosening and backout. The divergent and convergent orientation of the screws engaging in the humeral head prevent pull out and failure of fixation.