Does plate-screw density affect the functional outcomes in the treatment of proximal humerus fractures?

Between 1998 and 2002, 32 patients (11 males, 21 females), aged 26-78 years, with proximal humerus fractures were operated on. In 29 cases osseous osteosynthesis by AO technique with T- and L-shape plates and screws was performed, in 2 cases osteosynthesis was carried out using Kirshner wire and in 1 case with screws and wire. In all patients functional results were evaluated by American Shoulder and Elbow Surgeons system in terms from 7 to 48 months after operation. The following parameters were included: pain, movement range, muscular force, stability/instability of shoulder joint, limb function. In patients over 60 years movement range and limb function were reliably decreased compared to younger patients (p

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Prospective observational study evaluating the outcome of a fixed angle plate (proximal humerus internal locking system) in proximal humerus fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195804 ◽

2019 ◽

Vol 6 (1) ◽

pp. 117

Author(s):

Kiran Ramachandran ◽

Jackson Mathew ◽

Praveen Koraboina ◽

Ponnezhathu Sebastian John

Keyword(s):

Functional Outcomes ◽

Proximal Humerus ◽

Osteoporotic Fractures ◽

Attrition Rate ◽

Proximal Humerus Fractures ◽

Fixed Angle ◽

Significant Difference ◽

Humerus Fractures ◽

Study Participants ◽

Type Of Fracture

Background: Proximal humerus fractures are common among elderly. The present study assesses the functional outcomes of fixed angle plate (proximal humerus internal locking system (PHILOS)) in fractures of proximal humerus.Methods: 30 participants aged ≥18 years with proximal humerus fracture (2, 3 and 4 part) who underwent PHILOS fixation were enrolled. Undisplaced, open, severely comminuted, metastatic, and pathological fractures and with associated head injury and neurovascular injuries wew excluded. Clinical and radiological evaluation were done pre and post-operatively. Intraarticular extent of fracture geometry was assessed using 3-dimensional computed tomography. Participants were managed preoperatively with analgesics and shoulder immobilizer followed by preanesthetic check-up and routine investigations and surgery was done once participants were stable. Sample size was calculated assuming excellent or satisfactory results in 80% participants 6 months after surgery, relative precision of 20%, α of 5% and 10% attrition rate. Institutional ethics committee approved the study and written informed consent was obtained from all study participants.Results: Mean age of study participants was 62.9 (14.9) years and were predominantly females (66.6%, n=20). No significant difference between type of fracture and duration of recovery was observed (p=0.4). 30% participants had post-operative complications, stiffness was the most common (13.3%, n=4) complication. 76.6% (n=23) participants had good functional outcomes. Significant correlation between type of fracture and NEER score was observed (p<0.0001).Conclusions: PHILOS is a preferential implant in proximal humerus fractures due to angular stability, particularly in comminuted fractures in younger patients, and osteoporotic fractures in elderly, thus allowing early mobilization and satisfactory final functional outcome.

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Functional outcomes in proximal humerus fractures: a prospective registry-based analysis

Journal of the Pakistan Medical Association ◽

10.47391/jpma.04-600 ◽

2021 ◽

pp. 1-6

Author(s):

Tashfeen Ahmad ◽

Zehra Abdul Muhammad ◽

Amna Haroon

Keyword(s):

Upper Limb ◽

Functional Outcomes ◽

Proximal Humerus ◽

Care Hospital ◽

Proximal Humerus Fractures ◽

Treatment Groups ◽

Significant Difference ◽

Humerus Fractures ◽

Limb Fractures ◽

Upper Limb Fractures

Abstract Objective: To evaluate clinical and functional outcomes of proximal humerus fractures managed with different procedures and determining factors influencing outcomes. Methods: Data of this prospective cohort was obtained from the orthopaedic trauma registry at a tertiary care Hospital from June 2015 to October 2019. Sixty-nine adult patients with proximal humerus fracture managed either surgically or non-operatively were identified. Functional and clinical outcomes had been assessed using Quick Disability of the Arm, Shoulder and Hand score. Outcomes were assessed up to 12 months follow-ups and were compared between different treatment groups and between isolated versus proximal humerus with additional upper limb fractures. Results: In the 69 patients, 31 (45%) belonged to >55 years age group. Fifty-eight (84%) patients were operated of which 43 (62%) underwent Proximal Humeral Internal Locking System procedure. There was non-significant difference in clinical and functional outcomes between isolated versus proximal humerus fractures associated with other upper limb fractures at follow-ups 6 weeks onwards. At 3 months follow-up, there was significantly better outcomes in all treatment groups compared to PHILOS with bone graft/BMP (p=0.004-0.035). Males had significantly better recovery at 3 months as compared to females (p=0.04). Continuous...

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A study of proximal humerus fractures treated by PHILOS plating in a tertiary care hospital

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20193133 ◽

2019 ◽

Vol 5 (5) ◽

pp. 838

Author(s):

S. Srikanth ◽

A. Varun Kumar Reddy ◽

Gudapati Omkarnath

Keyword(s):

Functional Outcomes ◽

Proximal Humerus ◽

Tertiary Care ◽

Care Hospital ◽

Proximal Humerus Fractures ◽

Locking Plates ◽

Poor Bone Quality ◽

Comminuted Fractures ◽

Philos Plate ◽

Humerus Fractures

Background: Proximal humeral fractures are commonly presented in the orthopedic practice. The usual method of treatment was conservative in the past. However, the results and functional outcomes were not good. With the development of PHILOS locking plates, the functional outcomes are known to be improved. We in the present study tried to evaluate the functional outcomes of proximal humerus fractures treated with PHILOS plates.Methods: This prospective study was conducted in all Adult patients with closed two-part and three-part fractures of the proximal humerus, those who have reported within a week of the injury were included in the study. A total of n=30 patients were included in the study based on the inclusion and exclusion criteria. A standard surgical approach with PHILOS plate was used and patients were followed up for 19 to 24 months.Results: n=30 patients out of which n=16 (53.33%) were males and n=14 (46.67%) were females. The most common age group involved in the fractures was 31-35 years n=9 (30%) of the patients. Most of the patients n=21 (70%) were having Neer's two-part fractures and three-part fractures were found in n=6 (20%) and four part in n=3 (10%). The overall results in the study were 66.67% of patients had excellent results and 16.67% had good results and 10% had poor results.Conclusions: PHILOS locking plates is a better treatment option for fractures of proximal humerus especially in cases of poor bone quality and comminuted fractures.

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