To assess the functional outcome of 3-Part and 4-Part proximal humerus fracture treated by philos

Abstract

Background: Majority of the fractures of proximal humerus are relatively common injuries in adults and are low-energy osteoporotic fractures. In the current study proximal humerus fracture 3 and 4 part were treated by PHILOS fixation technique depending on the fracture pattern and assessment of the functional outcome was done so as to provide some inference regarding the functional outcome and patient selection. Material and methods: We received 183 patients with proximal humerus fracture in our institute from December 2019 to December 2020, out of which 23 were 3- part and 13 were 4-part, with predominance to elderly and female. Out of 36 total patients 32 (20 3-part and 12 4-part) were operated by PHILOS. Results: In 3-part fracture CMS and ASES score at 6 month follow up were 78.5 and 77 respectively and in 4 part fracture functional score at 6 month follow-up CMS-62 and ASES 64.2. Conclusion: Patient with 3-part fracture showed good recovery and good functional recovery, but guarded by the age and other patient related factor. In 4-part fracture the functional recovery and union are fracture dependent as the patient did not complain of pain and stiffness, but in a demanding patient ROM and joint ability is compromised. This limitation of the management choice in these fracture are highly directed by the status and requirement of patient, it showed good result in 3-part fracture but 4 –part fracture results were not satisfactory.