GN Kiran Kumar,Gaurav Sharma,Vijay Sharma,Vaibhav Jain,Kamran Farooque,Vivek Morey.[J].Chin J Traumatol,2014,17(5):279-284. [doi]

Surgical treatment of proximal humerus fractures using PHILOS plate

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KeyWord: Proximal humerus fracture Fracture fixation, internal Proximal humeral internal locking system

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Author Name	Affiliation
GN Kiran Kumar	Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
Gaurav Sharma	Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110030, India
Vijay Sharma	Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110031, India
Vaibhav Jain	Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110032, India
Kamran Farooque	Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110033, India
Vivek Morey	Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110034, India

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Abstract:

Objective: To evaluate functional outcome and complications of open reduction and internal fixation with proximal humeral internal locking system (PHILOS) plate for proximal humerus fractures. Methods: We reviewed 51 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2007 to 2012. There were 35 men and 16 women with a mean age of 38 years (range 24-68). There were 41 patients in the age group of <60 years and 10 patients in the age group of >60 years. According to Neer classification system, 8, 15 and 23 patients had 2-part, 3-part, and 4-part fractures, respectively and 5 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma centre. Functional evaluation of the shoulder at final follow-up was done using Constant-Murley score. Results: The mean follow-up period was 30 months (range 12-44 months). Two patients were lost to followup. Of the remaining 49 patients, all fractures were united clinically and radiologically. The mean time for radiological union was 12 weeks (range 8-20 weeks). At the final follow-up the mean Constant-Murley score was 79 (range 50-100). The results were excellent in 25 patients, good in 13 patients, fair in 6 patients and poor in 5 patients. During the follow-up, four cases of varus malunion, one case of subacromial impingement, one case of deep infection, one case of intraarticular screw penetration and one case of failure of fixation were noted. No cases of avascular necrosis, hardware failure, locking screw loosening or nonunion were noted. Conclusion: PHILOS provides stable fixation in proximal humerus fractures. To prevent potential complications like avascular necrosis, meticulous surgical dissection to preserve vascularity of humeral head is necessary.

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