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

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.

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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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2020/466 ◽

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

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Outcome of locking plate fixation for proximal humerus fractures

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20160712 ◽

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

Background: 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.Methods: 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 <60 years and 8 patients in the age group of >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.Results: 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.Conclusions: 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.

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PROXIMAL HUMERUS FRACTURES;

The Professional Medical Journal ◽

10.29309/tpmj/2017.24.12.571 ◽

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.

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Study of functional outcome of proximal humerus fractures managed by open reduction and internal fixation with locking compression plate at a tertiary hospital

MedPulse International Journal of Orthopedics ◽

10.26611/10201721 ◽

2020 ◽

Vol 17 (2) ◽

pp. 15-19

Author(s):

Snehal Hedgire ◽

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Open Reduction ◽

Proximal Humerus ◽

Tertiary Hospital ◽

Locking Compression Plate ◽

Proximal Humerus Fractures ◽

Compression Plate ◽

Humerus Fractures

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Functional outcome following open reduction and internal fixation of proximal humerus fractures with locking compression plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20205465 ◽

2020 ◽

Vol 7 (1) ◽

pp. 29

Author(s):

Mohamed Nishad M. ◽

Mohamed Shakeeb K. U. ◽

Gijo A. J.

Keyword(s):

Internal Fixation ◽

Functional Outcome ◽

Treatment Modality ◽

Open Reduction ◽

Proximal Humerus ◽

Proximal Humerus Fractures ◽

Road Accidents ◽

Locking Compression Plates ◽

Life Style Changes ◽

Humerus Fractures

Background: Proximal humerus fractures (PHFs) are common upper extremity fractures representing break in humerus bone. Incidences of PHFs increased in last few years due to life style changes and increased road accidents. Appropriate management strategy for PHFs is still uncertain. The aim of current study is to assess the functional outcome following open reduction and internal fixation of proximal humerus fractures using locking compression plates.Methods: Current study is a descriptive investigation conducted on 31 PHFs patients admitted to baby memorial hospital, calicut, between January 2013 to June 2014. Surgical management of PHFs was done by open reduction and internal fixation using locking compression plates and functional outcomes and complications of the employed treatment modality were investigated.Results: PHFs were observed to be common in 41-60 years age group, with 65% males being affected. Road accidents and domestic falls were observed to be the most common causes of PHFs in younger and elderly populations respectively. Three parts PHFs were observed to be more prevalent, followed by two and four parts fractures. Results of current study revealed that majority of PHFs united by 8-10 weeks duration with 22.58% cases with excellent and 41.93%, 16.12% and 19.35% cases with good, moderate and poor constant and Murley score respectively. Two patients reported post-operative complication of shoulder stiffness, while one patient each reported plate impingement, varus maluion, infection and varus malunion with intraarticular screw cut-out. Conclusions: Locking compression plates (PHILOS/PHLP) is an efficient treatment modality for proximal humerus fractures allowing early mobilization and good functional outcome.

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