Vipin Kumar1 , Afroz Ahmed Khan2 , Ruchit Shah3 , Sharib Shamim4 , Nandan Kumar Mishra5 , Imram Shakeel Khan6
BACKGROUND Fracture of proximal humerus is the second most common fracture of the upper extremity, following distal forearm fractures the incidence of these fractures are increasing especially in the elderly due to osteoporosis1 . PHILOS (Proximal Humerus Internal Locking System) is part of the latest generation of locking compression plates for proximal humeral fracture fixation. The aim of this study was to evaluate the clinical and functional outcome of PHILOS plate in displaced proximal humeral fractures. METHODS Functional outcomes of 12 men and 18 women aged 22 to 78 (mean, 58) years who underwent PHILOS plate fixation for fracture proximal humerus under general anaesthesia were recorded. Indications for surgery were part 2 (n= 9), part 3 (n= 14) or part 4 (n= 7) closed proximal humeral fractures with angulation of more than 45 degrees or displacement of more than 1 cm. Functional outcomes and shoulder range of movement were assessed based on the constant scoring system. All patients were followed up at monthly intervals for 6 months. During this period patient were motivated for physiotherapy and gradual normal use of the affected limb. Fracture union was assessed clinically and radiologically. RESULTS In our study of fracture proximal humerus, union in most of the cases (24) occurred between 10-14 weeks. Range of union time was 8 to 18 weeks. One case of avascular necrosis of head occurred in our case. Out of 30 cases, results were excellent in 7 cases, good in 16 cases, satisfactory in 5 cases and poor in 2 cases. CONCLUSIONS PHILOS plate fixation is good treatment option for proximal humeral fractures particularly in osteoporotic bones.
