A prospective study showing functional outcome & complications following PHILOS plating in proximal humerus fractures

Abstract

Background: Significant controversy continues regarding the best methods of treating displaced proximal humerus fractures. Over last 3 decades, various modalities of fixations have evolved for proximal humerus fractures (like k-wires, screw fixation, T-buttress plate, conventional plate, locking plate & prosthetic replacement). Because they provide rigid anatomical fixation & higher angular stability, the proximal humerus locking plate is now the implant of choice for treating displaced proximal humerus fractures. Objective: To evaluate functional outcome & complications of PHILOS (Proximal humerus internal locking system) plating in proximal humerus fracture. Material &Methods: This prospective study include, a total 40 patients with displaced proximal humerus fracture, who were managed surgically with open reduction & internal fixation with PHILOS plating either by deltopectoral or deltoid splitting approach, between September 2019 to September 2020. Graded physiotherapy done in postoperative period. Average follow up period was 6 months. During follow up functional outcome was assessed by Neer’s score, fracture union was assessed radiologically, complications arrived if any, were managed accordingly. Results: Out of 40 patients, thirty patients having excellent, seven patients had satisfactory, two patients had unsatisfactory, one patient was failure according to Neer’s score. Mean Neer’s score was 89.05. Out of 40 patients, six developed various complications like shoulder stiffness, varus malunion, postoperative infection, implant loosening, avascular necrosis of humeral head. Average time taken for the fracture union was 12 weeks, assessed radiologically. Conclusion: PHILOS plating for displaced& comminuted proximal humerus fractures have results in excellent functional& radiological outcome with minimal complications.