scholarly journals Outcome of locking plate fixation for proximal humerus fractures

2016 ◽  
Vol 2 (1) ◽  
pp. 25
Author(s):  
Neil Rohra ◽  
Jimmy Chokshi ◽  
Rishi Sanghavi
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Evaluation Criteria ◽  
Proximal Humerus Fractures ◽  
Age Group ◽  
Philos Plate ◽  
Humerus Fractures ◽  
The Mean

<p class="abstract"><strong>Background:</strong> The objective of the study was to evaluate functional outcome of open reduction and internal fixation with proximal humeral internal locking system (PHILOS) plate for proximal humerus fractures.</p><p class="abstract"><strong><span lang="EN-US">Methods:</span></strong><span lang="EN-US"> We reviewed 30 patients who underwent open reduction and internal fixation with PHILOS plate between the years 2010 to 2015. There were 23 men and7 women with a mean age of 36 years (range 20-64).There were 22 patients in the age group of &lt;60 years and 8 patients in the age group of &gt;60 years. According to Neer classification system, 12, 11 and 4 patients had2-part, 3-part, and 4-part fractures, respectively and 2 patients had 4-part fracture dislocation. All surgeries were carried out at our tertiary care trauma center. Functional evaluation of the shoulder at final follow-up was done using Neer’s Evaluation Criteria.</span></p><p class="abstract"><strong><span lang="EN-US">Results:</span></strong><span lang="EN-US"> The mean follow-up period was 20 months (range 14-40 months). All fractures united clinically and radio logically. The mean time for radiological union was 13.2 weeks (range 9-26 weeks).At the final follow-up the mean Neer’s Evaluation Criteria was 90 (range 76-100). The results were excellent in 17patients, Satisfactory in 8 patients, Unsatisfactory in 4 patients and Failure in 1 patient. During the follow-up, 3 cases of varus malunion, 1 case of failure of fixation were noted. No cases of AVN, hardware failure, locking screw loosening, infection or nonunion were noted.</span></p><p class="abstract"><strong><span lang="EN-US">Conclusions:</span></strong><span lang="EN-US"> PHILOS provides stable fixation in proximal humerus fractures. In order to prevent the complications like avascular necrosis, knowledge of anatomy and vascular supply of head of humerus and good surgical dissection to preserve vascularity of humeral head is important.</span></p>

scholarly journals PROXIMAL HUMERUS FRACTURES;

2017 ◽  
Vol 24 (12) ◽  
pp. 1788-1793
Author(s):  
Faisal Abdul Jabbar ◽  
Rehana Ali Shah
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Avascular Necrosis ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Case Series ◽  
Proximal Humerus Fractures ◽  
Humerus Fractures ◽  
The Mean

Objectives: The aim of our study is to study the radiological and functionaloutcome of proximal humerus fractures treated via open reduction and internal fixation usingthe proximal humerus internal locking system or PHILOS. Study Design: Case series study.Period 05 years duration from January 2011 to December 2015. Setting: Large tertiary carecentre in Karachi, Pakistan. Materials and methods: The study population consisted of n=50patients all of whom underwent open reduction and internal fixation utilizing the proximalhumeral internal locking system or PHILOS for fractures of the proximal humerus. The inclusioncriterion was all the patients with closed fractures of the proximal humerus and were belongingto 2,3 and 4 part of the Neer system of classification. Physiotherapy was started as soon aspossible for the patients. Serial radiographic imaging in two views was done at 6, 12, 24 and52 weeks postoperatively. For the functional outcome of the procedure Constant and Murleyscoring system was used. Data was analyzed using IBM SPSS version 21. Results: The studypopulation consisted of n= 50 patients of which n= 35 were males and n= 15 were femaleshaving a mean age of 38.50 years. The mean duration of follow up was 24 months. All thepatients in the study had union of fracture both radiographically and clinically, the mean timeduration for the radiographically evident union of the humerus bone was 12 weeks with a rangeof 8 to 20 weeks, the mean Constant Murley score for the functional outcome of the shoulderjoint was 79 at the final follow up with a range of 50 to 100. Complications were found in n= 9patients and varus malunion was the most common complication. In our case series we did notobserve complications such as avascular necrosis, non union or implant failure. Conclusion:According to the results of our study the proximal humerus internal locking system or PHILOSis a good method for open reduction and internal fixation of the proximal humerus fractures andprovides a stable fixation, and has lower incidence of complications such as avascular necrosis.

scholarly journals FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH OPEN REDUCTION AND INTERNAL FIXATION WITH A LOCKING COMPRESSION PLATE: A CROSS SECTIONAL STUDY

2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Constant Score ◽  
Locking Compression Plate ◽  
Proximal Humerus Fractures ◽  
Compression Plate ◽  
Humerus Fractures ◽  
The Mean

Proximal humerus fractures account for about 4% to 5% of all fractures. Following distal forearm fracture, proximal humeral fracture is the second most common upper extremity fracture. Kirschner (K)-Wires, external fixation, tension band wiring, and rush pins, intramedullary nails, ORIF with plates, and shoulder hemiarthroplasty have all been offered as therapeutic options. The purpose of this study was to assess the functional outcome and complication rates following internal fixation of proximal humerus fractures using a locking compression plate. Patients over the age of 18 with closed proximal humerus fractures or open proximal humerus fractures (Gustilo and Anderson type I, Type II) received open reduction and internal fixation with locking compression plate in the current study. The participants in this study were 60 people who had a proximal humerus fracture and were treated with open reduction and a proximal humerus locking compression plate. Patients ranged in age from 20 to 85 years old, with a mean age of 51.14 +/- 17.30 years. The age group 36–55 years (37 percent) was the most prevalent, followed by 56–75 years (30 %). The majority of patients (76.7 %) were men who had been in automobile accidents on the right side (83 %) (63 %). According to the Neer classification, the most prevalent type of fracture was a three-part fracture (53 %). The maximum union time observed in this study was 16 weeks, with a minimum of 10 weeks. The average time to union is 12.52 +/- 1.14 weeks. The mean flexion at the end of six months was 121.660 +/- 19.84. The mean internal rotation was 57.330 +/- 8.48, the mean external rotation was 530 +/- 11.98, and the mean abduction was 1180 +/- 19.36. 75.28 +/- 9.66 [Mean +/- SD] is the Mean Constant score. Pain 14.10, ADL 18.26, range of motion 22.46, and power 20 were the mean scores observed on Constant Score for its various aspects. According to the Constant score, the functional outcome of the 60 patients was as follows: 8 patients had excellent outcomes (13%), 34 patients had good outcomes (56.7%), 16 patients had moderate outcomes (26.7%), and two patients had poor outcomes (26.7%) and (3 %). Internal fixation of proximal humerus fractures with a locking compression plate results in anatomical reduction and secure fixation, resulting in a favorable functional outcome.

scholarly journals A Comparative Study of Open Reduction and Internal Fixation with PHILOS Plate versus Closed Reduction and Fixation with Percutaneous K Wiring of Neer’s 2-Part and 3-Part Proximal Humerus Fractures

2020 ◽  
Vol 7 (40) ◽  
pp. 2247-2250
Author(s):  
Mahesh Gangaiah ◽  
Monesh Kanakappa Basavaraj ◽  
Balaraj Gowda Hanumantappa ◽  
Girish Halasinanagenahalli Rudrappa ◽  
Balakrishnan Honnapura Doppapettigama ◽  
...  
Keyword(s):  
Comparative Study ◽  
Internal Fixation ◽  
Closed Reduction ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Plate Versus ◽  
Proximal Humerus Fractures ◽  
Philos Plate ◽  
Humerus Fractures

scholarly journals Evaluation of functional outcome of proximal humerus fractures managed by open reduction and internal fixation with philos plate

2020 ◽  
Vol 6 (2) ◽  
pp. 403-410
Author(s):  
Dr. Rishi Solanki ◽  
Dr. Sharvin K Sheth ◽  
Dr. RA Solanki ◽  
Dr. Rahil Pankajkumar Shah ◽  
Dr. Vats Ganesh Joshi ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Functional Outcome ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Philos Plate ◽  
Humerus Fractures

scholarly journals Analysis of surgical fixation of displaced proximal humerus fractures using PHILOS plate

2016 ◽  
Vol 2 (4) ◽  
pp. 245
Author(s):  
Lalith Mohan Chodavarapu ◽  
Sreekanth Kashayi Chowdojirao ◽  
Avinash Gonu ◽  
Chandrasekhar Patnala ◽  
Vijay Krishna Chilakamarri
Keyword(s):  
Proximal Humerus ◽  
Dash Score ◽  
Proximal Humerus Fractures ◽  
Independent Observer ◽  
Constant Murley Score ◽  
Fracture Dislocations ◽  
Philos Plate ◽  
Humerus Fractures ◽  
The Mean

<p class="abstract"><strong>Background:</strong> The treatment of displaced proximal humeral injuries still throws challenges in identifying variables to prognosticate the outcome and optimizing a good clinical result. This study attempts to analyze the functional outcome of surgery of such fractures with proximal humeral interlocking system (PHILOS) plate and evaluate variables which help in predicting the prognosis.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective and prospective study of 30 patients with displaced proximal humerus fractures - 2 part, 3 part, 4 part and fracture dislocations according to Neer classification, surgically treated using PHILOS plate during 2011 and 2014. Evaluation of patients was done on follow-up by an independent observer for union by radiographs and functional assessment by Constant-Murley score and DASH (disabilities of the arm, shoulder and hand) score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean age of the patients was 40.4 years (range 18-65). 83.3% of the patients were male. The mean follow-up was 18.9 months (4-36 months). The mean Constant-Murley score and the DASH score were 76 and 16 respectively at the last follow-up. Our analysis showed that the patient’s age, delay in surgery, and Neer’s classification influenced the prognosis of the fracture. Medial metaphyseal extension in the fracture or an intact medial neck showed a better outcome. Complications were seen in 5 patients. Avascular necrosis was seen in 3 patients.</p><p><strong>Conclusions:</strong> Osteosynthesis of displaced proximal humeral fractures with PHILOS plate provides a good outcome, with low complication rate. Patient’s age and the type of fracture based on Neer’s classification prognosticate the outcome. </p>

A STUDY ON FUNCTIONAL OUTCOME OF PROXIMAL HUMERUS FRACTURES TREATED WITH PHILOS PLATING

2021 ◽  
pp. 5-7
Author(s):  
M.V. Sudhakar ◽  
R.Ashok kumar ◽  
A. Deepak ◽  
B.S.S.S. Venkateswarlu
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus ◽  
High Energy ◽  
Proximal Humerus Fractures ◽  
Non Union ◽  
Constant Murley Score ◽  
Philos Plate ◽  
Humerus Fractures ◽  
The Mean

Background: Proximal humerus fractures are common and debilitating injuries. These fractures have a dual age distribution occurring either in young people following high energy trauma Usually high energy trauma associated with dislocation or in those older than 60 years with low-velocity injuries like simple fall, especially in elderly patients is due to osteoporosis and deforming forces of muscle attached. Wide range of treatment modalities ranging from conservative management to reverse shoulder arthroplasty. The non-operative method gives good results in stable and minimally displaced fractures. Displaced humeral neck fractures used to be managed conservatively in the past, but these were complicated by loss of reduction, malunion, non-union, stiffness and ultimately poor functional outcome. We took up this study to assess the efcacy and functional outcome of P.H.I.L.O.S. plating in proximal humerus. Our objectives are to study the fracture pattern with the Neer's criteria, to reconstruct the proximal humerus fracture anatomically with Philos plate, allow early shoulder mobilization and assessing the functional outcome using Constant Murley score. It is an Materials and methods: observational study of 30 patients (18 females and 12 males) with proximal humerus fractures that attended to the Department of Orthopaedics, Government General Hospital, Rangaraya medical college, Kakinada from December 2018 to December 2020. The mean follow-up Results: period was 12 months. Two patients lost follow-up. Of the remaining 28 patients, all fractures were united clinically and radiologically. At the nal follow-up the mean Constant-Murley score was 69.2 (range 50 -100). The results were excellent in 3, good in 12, fair in 10 patients, poor in 3 patients. During the follow-up 4 cases had varus mal-union, 5 had stiffness of the shoulder, 2 had supercial infection and1 had screw penetration. No cases of hardware failure, locking screw loosening or non-union were noted. T Conclusion: he divergent and convergent orientation of the locking screws of PHILOS plate provides stable biological xation with good radiological union. It minimises the soft tissue dissection and gives both axial and angular stability hence, reducing the risk of fracture displacement.

scholarly journals Outcomes of the long philos plate for open reduction and internal fixation of complex proximal humerus fractures

Injury Extra ◽  
2012 ◽  
Vol 43 (10) ◽  
pp. 84-85
Author(s):  
A.I.W. Mayne ◽  
J.J.G. Malal ◽  
A.M. Noorani ◽  
M. Kent ◽  
M. Smith ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Open Reduction ◽  
Proximal Humerus ◽  
Proximal Humerus Fractures ◽  
Philos Plate ◽  
Humerus Fractures
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