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

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.

Download Full-text

Use of proximal humerus internal locking system plate in proximal humerus fractures and its relation with the functional outcome

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20195799 ◽

2019 ◽

Vol 6 (1) ◽

pp. 90

Author(s):

Prasanna Kumar G. S. ◽

Akash V. Mane ◽

Amit Kumar Yadav ◽

Abhishek Harsoor ◽

Jithsen Manna

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Proximal Humerus ◽

Constant Score ◽

Tertiary Care ◽

Care Hospital ◽

Proximal Humerus Fractures ◽

Excellent Outcome ◽

Good Outcome ◽

Humerus Fractures

Background: Proximal humerus fractures are the fractures occurs at or proximal to the surgical neck of the humerus, which accounts for 7% of all fractures and 80% of all humeral fractures. Now a days most of these fractures are managed with internal fixation because of better availability of anatomical plates. The aim was to assess the functional outcome and complications of proximal humerus fractures treated with proximal humerus internal locking system (PHILOS).Methods: This is a prospective study of 30 patients with two, three, and four parts proximal humerus fractures treated with proximal humerus internal locking sysyem from 2016 to 2018 with 25 to 80 years of age in a tertiary care hospital. Functional outcome is assessed by using constant murley shoulder scoring system.Results: Functional outcome as per constant score, 10 patients (33%) got excellent outcome, 06 patients (20%) got very good outcome, 07 patients got (23%) good outcome, 05 patients got (17%) fair outcome and 02 patients got (07%) poor outcome. Complications observed were superficial infections, implant failure and axillary nerve neuropraxia.Conclusions: Open reduction and internal fixation by using PHILOS is the ideal method in treating displaced proximal humerus fractures mainly in two and three part proximal humerus fractures which provides stable fixation and less complications.

Download Full-text

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...

Download Full-text

Study of functional outcome of surgical management of proximal humerus fracture by various modalities: a two-year study at a tertiary care hospital

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20200003 ◽

2020 ◽

Vol 6 (2) ◽

pp. 242

Author(s):

Addanki Vijayanand ◽

Narreddy Jayasomeswar

Keyword(s):

Functional Outcome ◽

Surgical Management ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Tertiary Care ◽

Humerus Fracture ◽

Significant Heterogeneity ◽

Care Hospital ◽

Proximal Humerus Fractures ◽

Humerus Fractures

Background: Proximal humerus fractures account for nearly 6-10% and are on a rise. The management of this is controversial and is challenging task. There is a significant heterogeneity among the studies in describing the best surgical procedure in proximal humerus fracture. The objective of the study is to assess and compare the functional outcome with different modalities in fixation of proximal humerus shaft fractures.Methods: A two-year prospective study was conducted after getting ethical approval at Narayana Medical College on cases admitted with proximal humerus fractures as per the inclusion criteria based on Neer’s classification. Radiological evaluation was done, and surgery was performed. Postoperative follow-up was done at 1st, 4th, 8th and 14th week and outcome were evaluated for each case based on Neer’s shoulder score.Results: 30 cases were included with a mean age of 48.2 years. Road traffic injury was common cause of fracture. Of the total 30 cases, 23 cases had excellent results, 4 cases were satisfactory, 2 cases were unsatisfactory, and one case had a failure. The mean scores observed on Neer’s score was pain (33.5 units), Function (23.5 units), range of motion (16.55 units) and anatomy (6.9 units).Conclusions: Clinical evaluation, obtaining proper radiological views, age of the patient and activity holds the key for realistic approach and surgical management of complex humerus fractures. Proper patient selection and thorough knowledge of the anatomy and biomechanical principles are the pre-requisites for a successful surgery and good functional outcome.

Download Full-text