Abstract: Background: Proximal humerus fractures are common and debilitating injuries and their incidence is increasing especially in elderly. Treatment of unstable, displaced, and comminuted fractures of the proximal humerus remains a challenging issue and significant controversy exists regarding the best method of treating these fractures. Various operative procedures are carried out nowadays, with the recent trend being internal fixation using locking plates. The present study is undertaken to evaluate the functional outcome of proximal humerus fractures treated by proximal humerus internal locking system (PHILOS) plate.
Methods: The proposed study is a prospective study conducted between May 2017 to June 2019 in a tertiary care center in Bangalore. In this study 30 post traumatic cases of proximal humeral fractures (Neers type 2, type 3) were treated by ORIF with proximal humerus internal locking system (PHILOS) plate and functional and radiological outcome was assessed using Constant score at 6weeks, 3months, 6months and 1year post-op.
Results: Majority of the patients in the study were males (63.3%), RTA being the commonest mode of injury in young population and fall being most common mode in elderly. 11(36.7%) and 19(63.3%) patients had Neers 2 part and 3 part fractures respectively. Radiologically, time to union ranged between 12 to 18 weeks. Mean constant score at one year follow-up was 73.63 and it was found that there was a significant reduction in favorable outcome with increase in age (p< 0.001).
Conclusion: PHILOS plating has a good functional outcome for proximal humerus fractures. Accurate anatomical reduction and early fracture fixation are essential for good functional outcome. A proper surgical technique will minimize complications and an aggressive rehabilitation regime will ensure the best possible functional outcome for the patient.
