Comparative evaluation of functional outcomes of proximal humerus fractures treated with PHILOS plate and K-wire fixation

Abstract

Background: Proximal humerus fractures are frequent shoulder injuries, particularly among the elderly with osteoporosis and in young adults following high-energy trauma. The optimal surgical treatment for displaced fractures remains debated. This study compares the functional outcomes of proximal humerus fractures treated with PHILOS plate and percutaneous K-wire fixation. Methods: A prospective comparative study was conducted on 80 patients with displaced proximal humerus fractures admitted to Medical College Baroda between 2018 and December 2019. Forty patients underwent fixation with a PHILOS plate (Group A) and forty with percutaneous K-wire fixation (Group B). Patients were followed up for one year. Outcomes were assessed using the Constant-Murley Score and radiological union time. Statistical analysis was performed using Student’s t-test. Results: The mean patient age was 53.8 years (range 25-75). The average Constant-Murley Score at final follow-up was 83.2 ± 5.8 in the PHILOS group and 73.4 ± 6.1 in the K-wire group (p < 0.001). Radiological union occurred at a mean of 13.4 weeks in the PHILOS group and 11.1 weeks in the K-wire group. Complications were more frequent in the K-wire group, including pin loosening (15%), superficial infection (10%), and varus malunion (7.5%). Conclusion: PHILOS plate fixation offers superior stability and functional outcome compared to K-wire fixation for displaced proximal humerus fractures. K-wire fixation remains a useful and economical option for simple, minimally displaced fractures and elderly low-demand patients.