scholarly journals Assessment of functional outcome of surgical management of proximal humerus fracture treated with PHILOS plate

2018 ◽  
Vol 4 (5) ◽  
pp. 736
Author(s):  
Jairam D. Jagiasi ◽  
Mihir R. Patel ◽  
Sagar G. Daliya ◽  
Amol Bochare ◽  
Manan Vora
Keyword(s):  
Functional Outcome ◽  
Scoring System ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Surgical Techniques ◽  
Functional Results ◽  
Operative Management ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Philos Plate

<p class="abstract"><strong>Background:</strong> Proximal humeral fractures were treated conservatively in the past and often had compromised functional results. With the advancement of surgical techniques, these fractures, especially displaced, are now more often managed operatively; to meet the needs of the patient, provide early rehabilitation and better functional outcome. The aim of this study was to assess the functional outcome of operative management of proximal humeral fractures with Philos plate fixation.</p><p class="abstract"><strong>Methods:</strong> In this prospective study, 30 patients aged 19-75 years (mean age 47.1 years) with fractures of the proximal humerus, including two-, three-, and four-part fractures, were treated by open reduction internal fixation with Philos plating. Patients’ functional outcomes were evaluated based on subjective (35 points) and objective (65 points) parameters, as per the constant scoring system.<strong></strong></p><p class="abstract"><strong>Results:</strong> Functional outcome based on the constant scoring system of the patient at 6 month follow-up were compared. Excellent results were seen in 12 patients (40%), 2 had very good results (6.66%), 9 patients were having good (30%) and 6 had fair (20%) functional outcome. One patient had poor functional results (3.33%). Avascular necrosis (AVN) of the humeral head was observed in one patients.</p><p class="abstract"><strong>Conclusions:</strong> Philos plate fixation for proximal humeral fractures provides good stable fixation with good functional outcome and is a feasible option.</p><p> </p>

scholarly journals Management of fracture upper end humerus with proximal humerus internal locking system

2017 ◽  
Vol 5 (5) ◽  
pp. 2134
Author(s):  
Sanjeev Sreen ◽  
Deepak Vashisht ◽  
Manjit S. Daroch
Keyword(s):  
Functional Outcomes ◽  
Proximal Humerus ◽  
Plate Fixation ◽  
Excellent Result ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Range Of Movement ◽  
Patient Will ◽  
Philos Plate ◽  
Distal Forearm Fractures

Background: Fracture of proximal humerus is the second most common fracture of the upper extremity, following distal forearm fractures. Aim of the present study was to evaluate the efficacy of proximal humerus internal locking system (PHILOS) plate fixation for proximal humerus fractures.Methods: Functional outcomes of 12 men and 18 women aged 22 to 78 (mean, 58) years who underwent PHILOS plate fixation for proximal humeral fractures were reviewed. Indications for surgery were 2 part (n=9), 3 part (n=14) or 4-part (n=7) closed proximal humeral fractures with angulation of more than 45 degrees or displacement of more than 1 cm. Functional outcomes and shoulder range of movement were assessed based on the Constant scoring system.Results: All patients will be followed up at monthly intervals for 6 months. During this period patient, will be motivated for physiotherapy and gradual normal use of the affected limb. Fracture union will be assessed clinically and radiologically. In our study of fracture proximal humerus union in most of the cases (24) occurring between 10-14 weeks. Range of union time was 8 to 18 weeks. one case of avascular necrosis of head occur in our case. In out of 30 cases excellent result in 7 cases, Good in16 cases Satisfactory in 5 cases and Poor in 2 cases were obtained.Conclusions: The PHILOS plate fixation is effective treatment for proximal humeral fractures particularly in osteoporotic bones.

scholarly journals Functional outcome of patients treated with proximal humeral internal locking osteosynthesis plate in proximal humeral fractures

2020 ◽  
Vol 6 (6) ◽  
pp. 1182
Author(s):  
Tigy Thomas Jacob ◽  
Manmatha Nayak
Keyword(s):  
Functional Outcome ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Articular Surface ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Humerus Fracture ◽  
Excellent Outcome ◽  
Osteosynthesis Plate ◽  
Philos Plate

<p class="abstract"><strong>Background:</strong> Displaced or unstable proximal humeral fractures fare poorly with non-operative treatment. These are better treated with surgical intervention in order to prevent minimal displacement of tuberosity or articular surface from compromising the long term articular function. The objective was to assess the functional outcome of patients treated with PHILOS (the proximal humeral internal locking osteosynthesis) plate in proximal humerus fracture.</p><p class="abstract"><strong>Methods:</strong> 42 patients age group range between 20 and 80 years 61.9% are male and 38.1% are female treated with philos plate. Functional outcome measured by using Constant and Murley score.<strong></strong></p><p class="abstract"><strong>Results:</strong> 50% were Neer two part fractures, 35.7%, three part fractures, 14.3%, four part fractures. After 6 month follow up functional outcome assessed by using constant and Murley score. Excellent outcome in 1 (2.4%) good outcome in 13 (31%), fair outcome in 19 (45.2%) and poor outcome in 9 (21.4%) noted.</p><p class="abstract"><strong>Conclusions:</strong> PHILOS plate fixation of proximal humerus fracture is an effective surgical technique in maintaining stability of fractures and there is significant improvement in functional outcome.</p>

scholarly journals Philos Plate Fixation for Displaced Proximal Humeral Fractures

2009 ◽  
Vol 17 (1) ◽  
pp. 15-18 ◽  
Author(s):  
MA Fazal ◽  
FS Haddad
Keyword(s):  
Plate Fixation ◽  
Functional Results ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Non Union ◽  
Philos Plate ◽  
Screw Penetration ◽  
The Mean ◽  
Metal Work ◽  
Shoulder Score

Purpose. To evaluate the treatment outcome of Philos plate fixation for displaced proximal humeral fractures in 27 consecutive patients. Methods. 6 men and 21 women aged 22 to 85 (mean, 56) years underwent Philos plate fixation for displaced proximal humeral fractures. 11 patients were aged ≤60 years and 16 >60 years. All fractures were closed with no associated injuries and classified as 2-part (n=13), 3-part (n=12), and 4-part (n=2), according to the Neer classification. Patients were assessed radiologically and functionally using the Constant shoulder score. Results. Patients were followed up for 6 to 24 (mean, 13) months. All the fractures united except in a 76-year-old woman with a 3-part fracture in whom there was fracture collapse and screw penetration of the humeral head at 6 weeks. She subsequently developed non-union and avascular necrosis. The mean Constant shoulder score was 70 (range, 28–88). 11 patients had a score exceeding 75, 13 were scored between 50 and 75, and 3 were below 50. Conclusion. Philos plate fixation provided stable fixation, minimal metal work problems and enabled early range-of-motion exercises to achieve acceptable functional results.

EVALUATION OF RESULTS OF PROXIMAL HUMERUS FRACTURE TREATED BY PHILOS PLATTING

2021 ◽  
pp. 71-72
Author(s):  
Kautilyakumar V. Mahida ◽  
Jyotish G. Patel ◽  
Ankit Patel
Keyword(s):  
Functional Outcome ◽  
Functional Outcomes ◽  
Proximal Humerus Fracture ◽  
Proximal Humerus ◽  
Constant Score ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Humerus Fracture ◽  
Complication Rates ◽  
Philos Plate

Purpose: To assess the functional outcome of proximal humerus fracture treated with Proximal Humerus Internal Locking osteosynthesis (PHILOS) plating. Methods: Functional outcomes of 30 patients aged 30 to 75 (mean 57) years who underwent Philos plate xation for proximal humeral fractures were evaluated after taking informed consent about the study. Indications for surgery were 2-part, 3-part or 4-part closed proximal humeral fractures with angulation of more than 45 degrees or displacement of more than 1 cm. All patients satisfying the inclusion criteria were operated and followed up for 6 months .Functional outcomes and shoulder range of movement were assessed based on the Constant scoring system and was done at 6 months postoperatively. Result: Patients were followed up for 6 months. All fractures healed satisfactorily. No wound infections, vascular injuries, avascular necrosis, or loss of xation ensued. One patients with axillary nerve palsy recovered spontaneously within 3 months. Functional outcome was excellent in 11 patients, good in 15, and moderate in 4. The mean Constant score was 83(range 40–100). Conclusion: Proximal humerus fractures treated by Open Reduction and Internal Fixation by Philos plate have good functional results with low complication rates.

scholarly journals Biomechanical evaluation of a new gliding screw concept for the fixation of proximal humeral fractures

2018 ◽  
Vol 7 (6) ◽  
pp. 422-429 ◽  
Author(s):  
Y. P. Acklin ◽  
I. Zderic ◽  
J. A. Inzana ◽  
S. Grechenig ◽  
R. Schwyn ◽  
...  
Keyword(s):  
Motion Tracking ◽  
Plate Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
High Rate ◽  
Initial Stiffness ◽  
Screw Perforation ◽  
Optical Motion ◽  
Biomechanical Evaluation ◽  
Philos Plate

Aims Plating displaced proximal humeral fractures is associated with a high rate of screw perforation. Dynamization of the proximal screws might prevent these complications. The aim of this study was to develop and evaluate a new gliding screw concept for plating proximal humeral fractures biomechanically. Methods Eight pairs of three-part humeral fractures were randomly assigned for pairwise instrumentation using either a prototype gliding plate or a standard PHILOS plate, and four pairs were fixed using the gliding plate with bone cement augmentation of its proximal screws. The specimens were cyclically tested under progressively increasing loading until perforation of a screw. Telescoping of a screw, varus tilting and screw migration were recorded using optical motion tracking. Results Mean initial stiffness (N/mm) was 581.3 (sd 239.7) for the gliding plate, 631.5 (sd 160.0) for the PHILOS and 440.2 (sd 97.6) for the gliding augmented plate without significant differences between the groups (p = 0.11). Mean varus tilting (°) after 7500 cycles was comparable between the gliding plate (2.6; sd 1.9), PHILOS (1.2; sd 0.6) and gliding augmented plate (1.7; sd 0.9) (p = 0.10). Similarly, mean screw migration(mm) after 7500 cycles was similar between the gliding plate (3.02; sd 2.85), PHILOS (1.30; sd 0.44) and gliding augmented plate (2.83; sd 1.18) (p = 0.13). Mean number of cycles until failure with 5° varus tilting were 12702 (sd 3687) for the gliding plate, 13948 (sd 1295) for PHILOS and 13189 (sd 2647) for the gliding augmented plate without significant differences between the groups (p = 0.66). Conclusion Biomechanically, plate fixation using a new gliding screw technology did not show considerable advantages in comparison with fixation using a standard PHILOS plate. Based on the finding of telescoping of screws, however, it may represent a valid approach for further investigations into how to avoid the cut-out of screws. Cite this article: Y. P. Acklin, I. Zderic, J. A. Inzana, S. Grechenig, R. Schwyn, R. G. Richards, B. Gueorguiev. Biomechanical evaluation of a new gliding screw concept for the fixation of proximal humeral fractures. Bone Joint Res 2018;7:422–429. DOI: 10.1302/2046-3758.76.BJR-2017-0356.R1.

scholarly journals Functional outcome in displaced proximal humeral fractures in adults treated by proximal humeral locking plates

2019 ◽  
Vol 6 (1) ◽  
pp. 178
Author(s):  
N. V. Narasimha Rao ◽  
K. Ravi Kanth ◽  
Rama Priya Yasam ◽  
T. Jaya Chandra
Keyword(s):  
Functional Outcome ◽  
Locking Plate ◽  
Proximal Humerus ◽  
Shoulder Function ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Medical College ◽  
Score Improvement ◽  
Average Improvement

<p class="abstract"><strong>Background:</strong> The management of proximal humerus fractures (PHF) is a challenging task to any surgeon. Study was conducted to evaluate the clinical and functional outcome of the proximal humeral internal locking system in fixation of displaced proximal humeral fractures.</p><p class="abstract"><strong>Methods:</strong> Study was conducted in the Department of Orthopedics, GSL Medical College. Informed written consent was taken from the study participants. All skeletally mature patients aged &gt;18 years, presenting with displaced PHF according to Neer two, three and four part fracture were included in the study. Either deltopectoral or deltoid splitting approach was used for surgery, post-operative rehabilitation was started on day one.<strong></strong></p><p class="abstract"><strong>Results:</strong> Twenty-five patients with PHF were enrolled in the study; five-holed proximal humerus locking plate (PHLP) was used for 18 patients, eight-holed PHLP for 05 and three-holed, ten-holed PHLP for 01 for one each. The Constant-Murley score was significantly improved (p=0.000) over each successive follow-up period with the average improvement of around 19 scores between 1<sup>st</sup> and 2<sup>nd</sup> follow-up and around 15 score improvement between 2<sup>nd</sup> and 3<sup>rd</sup> follow-up.</p><p class="abstract"><strong>Conclusions:</strong> The proximal humeral locking plate is an adequate device for the fixation of displaced two-part, three-part and four-part PHF. Patient can regain good shoulder function, resume normal activities much earlier.</p>

scholarly journals An evaluation of functional outcome following surgical management of fractures of the proximal humerus with Neer’s scoring system

2017 ◽  
Vol 4 (1) ◽  
pp. 46
Author(s):  
Yeshwanth Subash ◽  
Lydia M. ◽  
Kamalakumar K. ◽  
Ilavarasan M. Dhamu
Keyword(s):  
Functional Outcome ◽  
Surgical Management ◽  
Scoring System ◽  
Soft Tissues ◽  
Proximal Humerus ◽  
Articular Surface ◽  
Treatment Options ◽  
Early Mobilization ◽  
Functional Results ◽  
Non Union

<p class="abstract"><strong>Background:</strong> <span lang="EN-GB">Fractures of the proximal humerus are complex injuries associated with significant morbidity. Various options are available for management including non-operative treatment, depending upon the pattern of the fracture, quality of the bone and the surgeon's familiarity with the techniques. The age of the patient, physical activity and the medical fitness also largely influence the treatment options. The aim of this study was to evaluate the functional outcome following surgical management of these fractures and to compare the results with studies as available in literature</span><span lang="EN-IN">.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-GB">30 patients with fractures of the proximal humerus managed by surgical means were studied from January 2012 to January 2014 and were followed up for a minimum period of two years</span>.<strong></strong></p><p class="abstract"><strong>Results:</strong> <span lang="EN-GB">All the fractures treated united clinically by 8 weeks and radiologically by 16 weeks. There were no cases of delayed or non-union in our series. The fractures were more common in men with a gender distribution of 1.3:1 and were also more common in the age group of 50 to 65 years (53%). As per the Neer’s scoring system, 60% patients had excellent results while 33% patients had satisfactory results. They were all pain free and successfully returned to their pre-injury work. 6% patients had an unsatisfactory result</span><span lang="EN-IN">. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-GB">Surgical management of proximal humerus fractures following the principles of articular surface reconstruction, restoration of the anatomy, stable fixation, with minimal injury to the soft tissues and early mobilization, gives good functional results</span><span lang="EN-IN">.</span></p>

scholarly journals Radiological correlation with functional outcome in displaced proximal humerus fractures treated with locking plates: a prospective study of 35 cases

2018 ◽  
Vol 4 (3) ◽  
pp. 471
Author(s):  
Neetin Pralhad Mahajan ◽  
Nikhil Dilip Palange ◽  
Eknath D. Pawar ◽  
Hitesh Jivrajbhai Mangukiya ◽  
Ujwal Suryabhan Ramteke ◽  
...  
Keyword(s):  
Prospective Study ◽  
Functional Outcome ◽  
Proximal Humerus ◽  
External Rotation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plates ◽  
Range Of Movement ◽  
Maximum Improvement

<p class="abstract"><strong>Background:</strong> The objective of this prospective study is to investigate the relationship between the functional outcome and the radiographic results of two-, three- and four part proximal humeral fractures treated with open reduction and fixation with PHILOS locking plate.</p><p class="abstract"><strong>Methods:</strong> 35 patients (30 males and 5 females) with displaced proximal humerus fracture were treated with PHILOS plating and studied prospectively. According to Neer’s classification there were 16 two part fracture (45%), 15 three part fracture (42%) and 4 four part fracture (13%). The healing of fracture, head shaft angle (HSA) and complications were evaluated radiologically with plain radiographs whereas the functional outcome was assessed by the Shoulder Pain and Disability Index (SPADI) at 6 weeks, 3 months, 6 months and 1 year after surgery.<strong></strong></p><p class="abstract"><strong>Results:</strong> In our study, patients treated with locking plates had mean forward flexion of 123°, abduction of 124°, mean external rotation of 30° and internal rotation 53° at 1 year follow-up. Maximum improvement in range of movement occurred between interval of 12 weeks to 24 weeks due to complete fracture union occurred approximately up to 12 weeks. The mean SPADI score at end of 1 year were 10.22, 10.38 and 10.20 for two, three and four part fractures respectively. Average postoperative and follow-up HSA's were 134.1±4.4 and 132.5±1.2 degrees, respectively. Varus progression was more prominent in patients with postoperative HSA &lt;130 (p&lt;0.001). Complications included impingement in 1 case, joint penetration by screw in 1 case, failure of fixation in 1 case and infection in 1 case.</p><p class="abstract"><strong>Conclusions:</strong> Fixed angle locked plate is an extremely useful implant for reconstruction and salvage of proximal humeral fractures. Precise surgical technique, stable fracture fixation and restoration of anatomical reduction are absolutely necessary for improved outcome.</p>

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