scholarly journals Management of Proximal Humeral Fractures with Philos Plate- A Clinical and Radiological Outcome

2018 ◽  
Vol 6 (3) ◽  
Author(s):  
Dr Rajesh Kapila ◽  
Keyword(s):  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Radiological Outcome ◽  
Clinical And Radiological Outcome ◽  
Philos Plate

scholarly journals Review of Clinical and radiological outcome of 3- and 4-part proximal humerus fracture managed with J nails in elderly osteoporotic individuals.

2021 ◽  
Author(s):  
R M Chandak ◽  
Mohit Sharma ◽  
Amrit Jha
Keyword(s):  
Constant Score ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Radiological Outcome ◽  
Neck Shaft Angle ◽  
Clinical And Radiological Outcome ◽  
Shaft Angle ◽  
Pin Site ◽  
The Mean

Abstract Introduction: Proximal humeral fracture is 3rd most common fracture in elderly population.Selection of appropriate implant is always challenging to get optimum results in theseosteoporotic bones. Though locking plates are gold standard, major complications range from9% to 36%. Many percutaneous fixation techniques described in the literature are associated with pin site infections, pin backout and loss of reduction.Objective: To study clinical and radiological outcome of J nail technique for Neer’s three orfour part proximal humeral fractures in patients more than 60 years age.Materials and Method: We retrospectively studied 60 patients of 3 or 4 part proximal humeral fractures, >60 years of age treated with J nail technique from the period of 2015 to 2017. J nails were made using 2 mm 12 inches blunt tip L (Lambrinudi) wires. At final follow-up, clinical outcome was assessed using Constant Score and radiological evaluation was done according to the Bahr criteria. Statistical analysis was performed.Results: The mean Constant Score at final follow-up was 90. The postoperative reduction was excellent in 98% of patients and remained excellent in 90%. The mean postoperative neck shaft angle was 135.0° and final neck shaft angle was 131.4°. No deep infection was seen. No avascular necrosis of humeral head was found till follow up upto 2 yrs.Conclusions: Our study suggests that the functional and radiological outcomes obtained with J nailing are excellent and similar to locking plates and percutaneous Kirschner wire fixation with many other advantages of being simple, minimally invasive, avoiding muscle transfixation and no pin site infections. This surgical technique can be considered as one of the effective technique for fixation of proximal humeral fractures in elderly osteoporotics.

scholarly journals Clinical and radiological outcome of 3- and 4-part proximal humerus fracture managed with J nails in elderly osteoporotic individuals

2021 ◽  
Vol 7 (6) ◽  
pp. 1122
Author(s):  
R. M. Chandak ◽  
Mohit Sharma ◽  
Amrit Jha
Keyword(s):  
Constant Score ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Locking Plates ◽  
Radiological Outcome ◽  
Neck Shaft Angle ◽  
Clinical And Radiological Outcome ◽  
Shaft Angle ◽  
The Mean

<p class="abstract"><strong>Background:</strong> Proximal humeral fracture is 3rd most common fracture in elderly population. Selection of appropriate implant is always challenging to get optimum results in these osteoporotic bones. Though locking plates are gold standard, major complications range from 9% to 36%. To study clinical and radiological outcome of J nail technique for Neer’s three or four part proximal humeral fractures in patients more than 60 years age.</p><p class="abstract"><strong>Methods:</strong> We retrospectively studied 60 patients of 3 or 4 part proximal humeral fractures, &gt;60 years of age treated with J nail technique from the period of 2015 to 2017. J nails were made using 2 mm 12 inches blunt tip Lambrinudi wires. At final follow-up, clinical outcome was assessed using constant score and radiological evaluation was done according to the Bahr criteria.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean constant score at final follow-up was 90. The postoperative reduction was excellent in 98% of patients and remained excellent in 90%. The mean postoperative neck shaft angle was 135.0° and final neck shaft angle was 131.4°. No deep infection was seen. No avascular necrosis of humeral head was found till follow up to 2 years.</p><p class="abstract"><strong>Conclusions:</strong> Our study suggests that the functional and radiological outcomes obtained with J nailing are excellent and similar to locking plates and percutaneous Kirschner wire fixation with many other advantages of being simple, minimally invasive, avoiding muscle transfixation and no pin site infections.</p>

Our Early Results in Proximal Humeral Fractures Treated with Philos Plate

2016 ◽  
Vol 58 (1) ◽  
pp. 6
Author(s):  
Mustafa Kurklu ◽  
Yalcin Kulahci ◽  
Selim Turkkan ◽  
Arsen Arsenishvili ◽  
Harun Tuzun ◽  
...  
Keyword(s):  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Early Results ◽  
Philos Plate

scholarly journals Internal fixation of proximal humeral fractures using the philos plate

Injury Extra ◽  
2011 ◽  
Vol 42 (9) ◽  
pp. 112
Author(s):  
J. Broomfield ◽  
P. Ralte ◽  
A. Sinha ◽  
Y. Khan ◽  
C. Neophytou ◽  
...  
Keyword(s):  
Internal Fixation ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Philos Plate

scholarly journals A STUDY ON PROXIMAL HUMERAL FRACTURES STABILISED WITH PHILOS PLATE

2017 ◽  
Vol 4 (13) ◽  
pp. 711-716
Author(s):  
Praveen Sivakumar K ◽  
Syam Sunder B ◽  
Manikumar C.J
Keyword(s):  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Philos Plate

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 MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly

2021 ◽  
Vol 12 ◽  
pp. 215145932110439
Author(s):  
Guoyun Bu ◽  
Weitang Sun ◽  
Jian’an Li ◽  
Tao Yang ◽  
Mingxin Li ◽  
...  
Keyword(s):  
Blood Loss ◽  
Elderly Patients ◽  
Operation Time ◽  
The Elderly ◽  
Proximal Humeral Fractures ◽  
Humeral Fractures ◽  
Plate Group ◽  
Philos Plate ◽  
Fracture Types

Background Proximal humeral fractures (PHFs) account for 4–5% of all fractures in the elderly. There is still a controversy among the treatments in the displaced PHFs. Our aim was to explore the clinical outcome of PHFs with the treatment of MultiLoc nail or Philos plate in the elderly patients. Methods A total of 82 sustained elderly patients with PHFs were finally recruited between Dec 2016 and Dec 2017. 34 patients were treated with MultiLoc nail and 48 patients were treated with Philos plate. The demographics, fracture types, blood loss, operation time, union time, postoperative complications, visual analog scores (VASs), Constant scores, American Shoulder and Elbow Scores (ASESs), and neck-shaft-angle (NSA) between the two groups were compared. Results No differences were observed in the demographics, fracture types, VAS, Constant scores, and ASES scores between the two groups at final follow-up. Compared with the plate group, the blood loss, operation time, and union time were significantly lower in the nail group (all P < .05). The rate of general complications was 54.17% in the plate group, which was higher than that in the nail group (26.47%, P = .01). Three patients experienced reoperation in the plate group (3/48; 6.25%), but none in the nail group. Although there were no significant differences in intraoperative NSA between the two groups, the NSA at final follow-up in the nail group was much higher than the plate group (137.55 ± 5.53°vs 134.47 ± 5.92°, P = .02). Conclusions Multiloc intramedullary nail showed the similar effectiveness of final VAS, final Constant scores, and ASES scores in PHFs treatment with Philos plate. However, MultiLoc nail is superior to Philos plate in blood loss, operation time, complications, reoperation rate, and the change of NSA.

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>

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