To assess the functional outcome of proximal Humerus Fractures treated with Proximal Humerus Internal Locking System (PHILOS) platingIn Elderly age Group Population

2021 ◽  
Vol 09 (10) ◽  
Author(s):  
Dr Pushpvardhan Mandlecha ◽  
2021 ◽  
Vol 10 (4) ◽  
pp. 3266-3269
Author(s):  
Abhishek Patil

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.


2020 ◽  
Vol 6 (2) ◽  
pp. 919-923
Author(s):  
Dr. Sandip R Patil ◽  
Dr. Sapan Vora ◽  
Dr. Dhaval Tailor ◽  
Dr. Chitresh Mehta ◽  
Dr. Swapnil Chitnavis

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 ◽  
...  

2018 ◽  
Vol 4 (2.7) ◽  
pp. 889-892
Author(s):  
Dr. S Makesh Ram ◽  
Dr. M Antony Vimal Raj ◽  
Dr. G Mohan ◽  
Dr. Anand ◽  
Dr. M Rathna Kumar ◽  
...  

Author(s):  
Neil Rohra ◽  
Jimmy Chokshi ◽  
Rishi Sanghavi

<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>


2020 ◽  
Vol 9 (4) ◽  
pp. 247-253
Author(s):  
V. V. Gainullin ◽  
Т. B. Minasov ◽  
M. M. Bagautdinov ◽  
A. А. Akhmeldinova ◽  
E. R. Yakupova ◽  
...  

Introduction. Fracture of the proximal humerus is a common injury that accounts for up to 12 % of all bone fractures and up to 65 % of humeral fractures. 13 % to 16 % of fractures in this segment are multi-fragment with bone impression. This significantly complicates the task of internal fixation. This study aims to analyze the gender and age group distribution of patients with proximal humerus fractures, and morphological aspects of these injuries.Materials and methods. This paper presents a retrospective analysis of the epidemiological and morphological parameters of patients treated surgically for proximal humerus injuries at the Department of Traumatology and Orthopedics of the State Regional Clinical Hospital of the Republic of Bashkortostan № 1 in the city of Oktyabrsky in 2010–2016. The total of 191 patients were included in the study, 121 (63.35 %) females and 70 (36.65 %) males.Results and discussions. A signifi cant increase (more than three times) in the number of proximal humerus fractures was recorded in women in the 50–65 age group and in men in the 55–60 age group. The increase in the incidence of this type of injury does not exceed 22.4 % in comparison to the younger age groups. The increase in the number of injuries in question is undoubtedly due to changes in the bone metabolism in women. The analysis of character and morphology of fractures in women of older age groups indicates a greater prevalence of unstable injury of type 1.1.B and 1.1.C according to AO/ASIF classifi cation, which, again, is due to the demineralization of the segment determined by systemic metabolic abnormalities. The fi ndings indicate the need for perioperative monitoring of the bone metabolism parameters.Conclusion.The morphology and types of fractures depend on a patient’s age and bone quality. A signifi cant increase in this pathology in women of perimenopausal age refl ects changes in bone metabolism.


Author(s):  
Prasanna Kumar G. S. ◽  
Akash V. Mane ◽  
Amit Kumar Yadav ◽  
Abhishek Harsoor ◽  
Jithsen Manna

<p class="abstract"><strong>Background:</strong> 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).</p><p class="abstract"><strong>Methods:</strong> 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.<strong></strong></p><p class="abstract"><strong>Results:</strong> 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.</p><p class="abstract"><strong>Conclusions:</strong> 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.</p>


2013 ◽  
Vol 24 (5) ◽  
pp. 715-721 ◽  
Author(s):  
Yi Lu ◽  
Chunyan Jiang ◽  
Yiming Zhu ◽  
Manyi Wang ◽  
Richard J. Bowles ◽  
...  

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