Treatment of Proximal Humeral Fracture Using Polarus Nail and Philos Plate

BACKGROUND: To compare the treatment of the proximal humerus fracture using a Polarus nail or Philos plate, we aimed to analyze the functional recovery and the factors affecting the selection between the two types of surgery.METHODS: The study included 107 patients with proximal humerus fracture who underwent surgery at our institution. Of these patients, 67 underwent surgery with Polarus nails (G1) and 40 with Philos plates (G2). In G1, the cases of two- and three-part fractures were 60 and 7 cases, in G2, the cases of two-, three-, and four-part fractures were 28, 10, and 2 cases, respectively. The average age was 61 years old, and the average follow-up period was 32.5 months. We compared radiological results, the functional recovery retrospectively.RESULTS: The radiological union time was 6.8 weeks and 8.7 weeks on average in G1 and G2 (p < 0.05). At the one-year follow-up period, these were visual analogue scale (VAS) 1.355, forward flexion (FF) 130.968, external rotation (ER) 50.161, internal rotation (IR) L2 in G1, and VAS 0.781, FF 135.806 ER 51.25, IR L1 in G2, respectively, showing no significant differences between the two groups (p > 0.05). Similar observations were made at the final follow-up. In terms of functional recovery, no significant differences were seen at the one-year or at the final follow-up period (p > 0.05).CONCLUSIONS: For the surgical treatment of proximal humeral fracture, the selection of the type of surgery is affected by the fracture pattern. However, both methods give satisfactory outcomes and do not show significant differences in the functional outcome after the surgery.

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PHILOS Plate as a Fixation of Proximal Humeral Fracture: A Revisit

Borneo Journal of Medical Sciences (BJMS) ◽

10.51200/bjms.v0i0.1187 ◽

2019 ◽

pp. 39

Author(s):

Mohd Shaffid Md Shariff ◽

Hanizah Ngadiron ◽

Firdaus Hayati ◽

Nornazirah Azizan ◽

Affirul Chairil Ariffin

Keyword(s):

Proximal Humeral Fracture ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Surgical Intervention ◽

Motor Vehicle ◽

Humeral Fracture ◽

The Elderly ◽

Sport Injuries ◽

Vehicle Accidents ◽

Philos Plate

Fracture is common after trauma. Proximal humeral fracture can occur in the elderly after fall and in youngsters after motor vehicle accidents (MVA) and sport injuries. A 37-year-old man was admitted with a fracture of his left proximal humerus following an MVA. He sustained a 3-part fracture and treated surgically using a PHILOS plate. There are few options in managing proximal humerus fracture ranging from conservative to surgical intervention based on its severity. We reminiscent the usage of PHILOS plate as a mode of treatment of such fracture.

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SEVER INFERIOR HUMERAL HEAD SUBLUXATION FOR 3 MONTHS IN PROXIMAL HUMERUS FRACTURE DISLOCATION

International Journal of Advanced Research ◽

10.21474/ijar01/13339 ◽

2021 ◽

Vol 9 (08) ◽

pp. 870-873

Author(s):

Emad M. Allehyani ◽

Ahmed K. Alsarhani ◽

Ahmed Alsyed

Keyword(s):

Humeral Head ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Axillary Nerve ◽

Fracture Pattern ◽

Humerus Fracture ◽

Fracture Dislocation ◽

Medical Illness ◽

Patient Factors

Proximal humerus fracture is common fracture 4-6% of all fractures (1), third most common non vertebral fracture in elderly >65 years (2), affecting female more than males in ratios of 2:1.Approximately half (51%) of these fractures are displaced, the majority of which involve the surgical neck (77%). (3) Surgical treatment (mainly internal fixation or humeral head replacement) is being increasingly used (4).Management of each fracture is dependent of patient factors, fracture pattern, and complexity.Case scenario:33 years old female not known to has any medical illness, presented to the emergency department with right shoulder pain and inability to move it after motor cycle accident. X-rayshowed proximal humerusfracture dislocation Upon Post-operative follow up patient developed sever inferior humeral head subluxation, With intact axillary nerve sensation and motor exam.Discussion:proximal humerus fracture is common, fracture pattern and type, with patient factors will guide your management.proximal humerus fracture dislocation is more difficult and challenging to surgeon in managing such fracture, with inferior hemeral head subluxation is common can reach to 42% in the radiographic incidence among proximal humerus fracture.

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Philos plate fixation for proximal humerus fracture: Experience at District General Hospital

Injury Extra ◽

10.1016/j.injury.2011.06.274 ◽

2011 ◽

Vol 42 (9) ◽

pp. 121

Author(s):

S. Radha ◽

S. Senevirathna ◽

M. Saquib ◽

J. Harrison

Keyword(s):

General Hospital ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Plate Fixation ◽

District General Hospital ◽

Humerus Fracture ◽

Philos Plate

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Fixation of proximal humerus fracture in adult by locking plate: Clinical study

Surgical Update: International Journal of Surgery and Orthopedics ◽

10.17511/ijoso.2020.i05.07 ◽

2020 ◽

Vol 6 (5) ◽

pp. 325-332

Author(s):

Dr. Vivek Amritbhai Patel ◽

◽

Dr. Vishal A. Pushkarna ◽

Dr. Dhruvin J. Patel ◽

◽

...

Keyword(s):

Functional Outcome ◽

Proximal Humerus Fracture ◽

Locking Plate ◽

Proximal Humerus ◽

Plate Fixation ◽

Humeral Fracture ◽

Humerus Fracture ◽

Functional Evaluation ◽

Locking Plates ◽

Radiological Union

p>Aim: The present study aimed to examine the functional outcome of the locking plate in theproximal humerus fracture treatment. Material and Methods: The study consists of 20 patientsdiagnosed with NEER’s 2 – part, 3- part, and 4 – part proximal humerus fracture. All the includedpatients were treated with internal locking plates. Based on the functional evaluation by Constant-Murley shoulder score and the assessment of radiological union foundation. Results: Excellentresults were obtained in 45% of the patients, a good result was seen in 25%, 20% of the patientshad fair results and the poor result was seen in 10% of the patients. The mean Constant-Murleyshoulder score that was obtained in the present study was 75.04. Conclusion: It’s concluded thatthere is a satisfactory functional outcome with the fixation of the proximal humerus fracture withlocking plates. While using the plate fixation for fracture the plate position is of the utmostimportance. Due to angular stability, the locking plates are the advantageous implants in case ofproximal humeral fracture.

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Functional outcome of displaced proximal humerus fractures managed by proximal humerus interlocking system plate

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20171906 ◽

2017 ◽

Vol 3 (3) ◽

pp. 583

Author(s):

C. D. Deepak ◽

Mahesh D. V. ◽

Abdul Ravoof ◽

Manash Jyoti Baruah

Keyword(s):

Functional Outcome ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Road Traffic ◽

Osteoporotic Fractures ◽

Humerus Fracture ◽

Distal Radial Fractures ◽

Patients Âgés ◽

Philos Plate ◽

The Right

Background: Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age.Methods: The study was conducted in patients treated for displaced proximal humerus fracture at Adichunchanagiri Institute Of Medical Sciences, BG Nagar from the month of June 2014 to August 2016. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients’ age ranged from 18 to 75 years with a mean of 42.9.Results: The sample consisted of twenty patients of proximal humeral fractures. 08 were males and 12 females. The patients’ ages ranged from 18-75 years with a mean age of 42.9 years. The causes of fractures were road traffic accident in 13 patients, fall in 06 patients and electric shock in 1 patient. 11 fractures involved the right side and 09 involved the left. Patients were followed up from 03 weeks to 06 months. Functional outcome was rated as per Constant-Murley Shoulder Score, we got excellent results in 04 cases, satisfactory in 10, unsatisfactory in 05 xi and failure in 01 patient. Mean Constant-Murley score of this study at the end of the final follow-up period was 81.6. Conclusions: The PHILOS plate is a good implant to use for fractures of the proximal humerus. However, proper placement of the plate and fixation are required to produce satisfactory results. We recommend use of this implant in Neer 2-part, 3-part, 4-part fractures with or without dislocation and osteoporotic fractures.

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Study of operative management of proximal humerus fracture treated with locking plates

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20164161 ◽

2016 ◽

Vol 2 (4) ◽

pp. 318

Author(s):

Bhavik Y. Dalal ◽

Dipalkumar V. Rathod ◽

Raghav Suthar ◽

Harshal Damor

Keyword(s):

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Operative Management ◽

Humerus Fracture ◽

Shaft Angle ◽

Philos Plate ◽

Type 3 ◽

Radiological Union ◽

Head Shaft Angle ◽

Shoulder Score

Background: This study was undertaken to evaluate the efficacy of Philos plate and to specifically study the clinical outcome of the patient treated with Philos plate for proximal humerus fracture on the radiological head shaft angle basis.Methods: 40 cases of proximal humerus fracture fixed by using Philos plate were reviewed.Results: Average constant shoulder score as Neer type-3 fracture is 83.8% and for type- 4 part fracture is 86%. Average radiological union was seen at 10.2 weeks. There was no major difference in clinical and radiological union. Conclusions: Good functional outcome with Philos plate irrespective of fracture type was obtained.

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Internal Fixation of Proximal Humerus Fracture with Polyaxial Angular Stable Locking Compression Plate in Patients Older Than 65 Years

Clinics in Shoulder and Elbow ◽

10.5397/cise.2012.15.1.25 ◽

2012 ◽

Vol 15 (1) ◽

pp. 25-31 ◽

Cited By ~ 2

Author(s):

Ki Won Lee ◽

Young Joon Choi ◽

Hyung Sun Ahn ◽

Chung Hwan Kim ◽

Jae Kwang Hwang ◽

...

Keyword(s):

Internal Fixation ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Constant Score ◽

Locking Compression Plate ◽

Humerus Fracture ◽

Vas Score ◽

Compression Plate ◽

The Mean

PURPOSE: The clinical and radiographic outcomes of the internal fixation, which were executed on patients over the age of 65 with proximal humerus fracture by using a polyaxial angular stable locking compression plate (Non-Contact-Bridging proximal humerus plate, Zimmer, Switzerland, NCB), were evaluated.MATERIALS AND METHODS: Thirty two patients over the age of 65 among the proximal humerus fracture treated with NCB plate, between August 2007 and January 2011, were chosen as the subjects. The average age of patients was 71 years, and the average postoperative follow-up period was 11.5 months. The fractures included 14 two-part and 18 three-part fractures. The clinical results were evaluated, using the visual analog scale (VAS) score and the Constant score. The radiological results were evaluated by time to union and Paavolainen method, which measures the neck shaft angle.RESULTS: At the last follow-up examination, the mean VAS score was 3 points and the mean Constant score was 64.5 points, with bone union achieved after the average of 16.2 weeks following the surgery in all the cases. The mean neck shaft angle was 125.9 and 24 cases had good results, while 8 cases had fair results by Paavolainen method, at the last follow-up. There were 1 case of delayed union and cerclage wire failure, and 3 cases of subacromial impingement. There were no complications, such as loss of reduction, nonunion, screw loosening, or avascular necrosis of the humeral head.CONCLUSION: Internal fixation, using a NCB plate, was considered to be an effective surgical method in treating proximal humerus fracture in the elderly patients, on whom the fixation of the fracture and maintenance of reduction are difficult.

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Results of 131 consecutive operated patients with a displaced proximal humerus fracture: an analysis with more than two years follow-up

European Journal of Orthopaedic Surgery & Traumatology ◽

10.1007/s00590-010-0655-z ◽

2010 ◽

Vol 21 (1) ◽

pp. 7-12 ◽

Cited By ~ 29

Author(s):

D. Faraj ◽

B. W. Kooistra ◽

W. A. H. vd Stappen ◽

A. J. Werre

Keyword(s):

Proximal Humerus Fracture ◽

Proximal Humerus ◽

Humerus Fracture

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Selective Glenohumeral external rotation deficit – sequelae of post-ORIF deltoid adhesions after treatment of the proximal humerus fracture

BMC Musculoskeletal Disorders ◽

10.1186/s12891-020-03634-2 ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Michał Waszczykowski ◽

Jarosław Fabiś

Keyword(s):

Range Of Motion ◽

Proximal Humerus Fracture ◽

Proximal Humerus ◽

External Rotation ◽

Shoulder Function ◽

Humerus Fracture ◽

Plate Removal ◽

Special Regard ◽

Constant Murley Score

Abstract Background The deltopectoral approach is commonly used for plate stabilization of proximal humerus fracture. Although adhesions between the deltoid, plate, and humerus are common sequelae of plate ORIF, little is known about their effect on the range of movement and a function of the shoulder. To confirm their impact, the preoperative and intraoperative evaluation of the range of motion (ROM) was measured during the sequential arthroscopic release of adhesions, with special regard to external rotation. Postoperative ROM and subjective shoulder function were also evaluated. Methods Eighteen patients treated with ORIF of the proximal humerus were scheduled to the unified arthroscopic procedures comprising sequential limited subacromial bursectomy, removal of the adhesions between the deltoid, plate, and humerus, as well as the plate removal. The ROM of the operated and opposite shoulders were assessed before surgery, intraoperatively and after a minimum two-year follow-up, with special regard to external rotation in adduction (AddER) and abduction (AbdER). Besides, the Constant-Murley score and Subjective Shoulder Value (SSV) were evaluated before a plate removal and after a minimum two-year follow-up after the surgery. Results Deltoid adhesion release correlated with considerable and statistically significant improvement of AddER (p < 0.0002) but not with the intraoperative range of AbdER. Significant improvement of AddER, but also of AbdER and other range of motion was noted at the follow-up. The improvement of the affected shoulder function following arthroscopic plate removal was considerable and statistically significant according to the modified Constant-Murley score (p < 0,01) and SSV (p < 0.0000) after a minimum of two-year follow-up. Conclusions Our findings are the first to highlight the influence of deltoid muscle, plate, and humerus adhesions on limiting external rotation in adduction after ORIF treatment of proximal humerus fractures. These observations allow the identification of a new shoulder evaluation symptom: Selective Glenohumeral External Rotation Deficit (SGERD) as well as functional deltohumeral space.

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