A Comparative Study of Open Reduction and Internal Fixation with PHILOS Plate versus Closed Reduction and Fixation with Percutaneous K Wiring of Neerā??s 2-Part and 3-Part Proximal Humerus Fractures

Abstract

Mahesh Gangaiah1 , Monesh Kanakappa Basavaraj2 , Balaraj Gowda Hanumantappa3 , Girish Halasinanagenahalli Rudrappa4 , Balakrishnan Honnapura Doppapettigama5 , Venkata Sujith Varipy Reddy6

BACKGROUND We wanted to assess the clinical, functional, and radiological outcomes of two surgical treatment methods (K-wire application and PHILOS plate fixation) for proximal humerus fractures. METHODS A randomized prospective study was conducted between April 2017 and June 2018, 40 patients with Neer’s 2-part and 3-part displaced proximal humeral fracture who underwent surgical treatment were evaluated. Twenty patients were treated with closed-reduction percutaneous pinning and 20 patients were treated with open reduction internal fixation with proximal humerus anatomical plates. The results were compared clinically using the Constant-Murley shoulder outcome score (CMS) and radiologically with x rays. RESULTS The CMS of the Kirschner wire (K - wire) and plate groups did not differ significantly (p = 0.82671). The mean CMS values were 58.5 ± 15.04 for the PHILOS group and 59.4 ± 12.04 for the K - wire group. All fractures united 100 %. One case had stiffness and the other one had impingement in the PHILOS group. In the K wire group, one case had infection. CONCLUSIONS The clinical and radiological results of the PHILOS plate and K-wire groups were similar. Percutaneous fixation has the advantage of minimal invasiveness, which lowers the rate of complications. But PHILOS plate has the advantage of stable fixation and early mobilization.

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