Proximal humeral fractures are, an increasingly common fractures, accounting for 4%–5% of all and 45% of humeral fractures. 85% of these fractures are minimally displaced, effectively treated by immobilization followed by early range of motion exercises; the remaining 15% of these are either displaced or unstable. Neer’s classification evaluates the proximal humerus in four parts, any translations more than 1 centimeter or angulations more than 45 degrees in any part of the humerus are defined as displacement. PHILOS plate, since made of titanium is lighter with a good biocompatibility has an additional advantage over other implants for ORIF. The analysis of radiological and functional outcome of proximal humeral fractures managed with philos plate was the aim of this study. Results showed an excellent constant murley score in16%, good result 60%, fair result in 16% and poor in 8%. Mean constant murley score was 59.4. we concluded that proximal humerus locking plate (PHILOS) gives satisfactory functional outcome in patients with proximal humerus fractures

Keywords: proximal humerus, philos, constant murley score.

1. Palvanen M, Kannus P, Niemi S, Parkkari J. Update in the epidemiology of proximal humeral fractures. Clin Orthop 2006; 442:
   87–92.
2. Spence RJ. Fractures of the proximal humerus. Curr Opin Orthop 2003;14:269–80.
3. Baron JA, Barrett JA, Karagas MR. The epidemiology of peripheral fractures. Bone 1996;18(3):209–13.
4. Court-Brown CM, Garg A, McQueen MM. The epidemiology of proximal humeral fractures. Acta Orthop Scand 2001;72:365-71.
5. Chu SP, Kelsey JL, Keegan TH, Sternfeld B, Prill M, Quesenberry CP, et al. Risk factors for proximal humerus fracture. Am J Epidemiol 2004;160(4):360-7.
6. Magovern B, Ramsey ML. Percutaneous fixation of proximal humerus fractures. Orthop Clin North Am 2008;39(4):405-16.
7. Neer CS. Displaced proximal humeral fractures. I. Classification and evaluation. J Bone Joint Surg 1970; 52:1077-89.
8. Codman EA. The shoulder: rupture of the supraspinatus tendon and other lesions in or about the subacromial bursa. Boston, Thomas Todd; 1934:313–31.
9. Lupo R, Rapisarda SA, Lauria S, Palmisciano G. Plates with angular stability: our personal experience in surgical treatment of fractures of the proximal extremity of the humerus. Chir Organi Mov 2008;91(2):97-101.
10. Neer CS, Rockwood CA. Fracture and dislocations of the shoulder. In Rockwood CA, Green DP, editors: Fractures in adults 4^thed, Philadelphia; JB Lippincott 1996.
11. Brunner F, Sommer C, Bahrs C, Heuwinkel R, Hafner C, Rillmann P, et al. Open reduction and internal fixation of proximal humerus fractures using a proximal humeral locked plate: a prospective multicenter analysis. J Orthop Trauma 2009;23(3):163-72.
12. Magovern B, Ramsey ML. Percutaneous fixation of proximal humerus fractures. Orthop Clin North Am 2008;39(4):405-16.
13. Flatow EL, Cuomo F, Maday MG, Miller SR, McIlveen SJ, Bigliani LU. Open reduction and internal fixation of two-part displaced fractures of the greater tuberosity of the proximal part of the humerus. J Bone Joint Surg Am 1991;73(8):1213-8.
14. Habermeyer P, Schweiberer L. Fractures of the proximal humerus. Orthopade 1989;18(3):200-7.
15. Hawkins RJ, Bell RH, Gurr K. The three-part fracture of the proximal part of the humerus. Operative treatment. J Bone Joint Surg Am 1986; 68(9):1410-4.
16. Jakob RP, Miniaci A, Anson PS, Jaberg H, Osterwalder A, Ganz R. Four-part valgus impacted fractures of the proximal humerus. J Bone Joint Surg Br 1991;73(2):295-8.
17. Szyszkowitz R, Seggl W, Schleifer P, Cundy PJ. Proximal humeral fractures. Management techniques and expected results. Clin Orthop Relat Res 1993;(292):13-25.
18. Khodadadyan-Klostermann C, Raschke M, Fontes R, Melcher I, Sossan A, Bagchi K, et al. Treatment of complex proximal humeral fractures with minimally invasive fixation of the humeral head combined with flexible intramedullary wire fixation- introduction of a new treatment concept. Langenbecks Arch Surg 2002;387:153-60.
19. Wijgman AJ, Roolker W, Patt TW, Raaymakers EL, Marti RK. Open reduction and internal fixation of three and four-part fractures of the proximal part of the humerus. J Bone Joint Surg [Am] 2002;84:1919-25.
20. Helmy N, Hintermann B. New trends in the treatment of proximal humerus fractures. Clin Orthop 2006;442:100-8.
21. Neer CS 2nd. Displaced proximal humeral fractures. II. Treatment of three-part and four-part displacement. J Bone Joint Surg Am 1970; 52(6):1090-103.
22. Muller M, Nazarian S, Koch P, Schatzker J. The Comprehensive Classification of Fractures of Long Bones. Berlin, Germany: Springer-Verlag; 1990.
23. Sharafeldin KN, Quinlan JF, Corrigan J, Kelly IP. Functional follow-up of locking plate fixation of fractures of the proximal humerus. Eur J Orthop Surg Traumatol 2008;18:87-92
24. Klitscher D, Blim J, Andreas D.  Osteosynthesis of Proximal Humeral Fractures with the Fixed Angle PHILOS-plate. Eur J Trauma Emerg Surg 2008; 34:29-36.
25. Clavert P, Adam P, Bevort A, Bonnomet F, Kempf JF. Pitfalls and complications with locking plate for proximal humerus fracture. J Shoulder Elbow Surg 2010;19(4):489-94.
26. Egol KA, Ong CC, Walsh M, Jazrawi LM, Tejwani NC, Zuckerman JD. Early complications in proximal humerus fractures (OTA Types 11) treated with locked plates. J Orthop Trauma 2008;22(3):159-64.
27. Ricchetti ET, Warrender WJ, Abboud JA. Use of locking plates in the treatment of proximal humerus fractures. J Shoulder Elbow Surg 2010; 19(2):66-75.
28. Thalhammer G, Platzer P, Oberleitner G, Fialka C, Greitbauer M, Vécsei V. Angular stable fixation of proximal humeral fractures. J Trauma 2009;66(1):204-10.
29. Hirschmann MT, Fallegger B, Amsler F, Regazzoni P, Gross T. Clinical longer-term results after internal fixation of proximal humerus fractures with a locking compression plate (PHILOS). J Orthop Trauma 2011; 25(5):286-93.
30. Thyagarajan DS, Haridas SJ, Jones D, Dent C, Evans R, Williams R. Functional outcome following proximal humeral interlocking system plating for displaced proximal humeral fractures. Int J Shoulder Surg 2009;3(3):57-62.
31. Thanasas C, Kontakis G, Angoules A, Limb D, Giannoudis P. Treatment of proximal humerus fractures with locking plates: a systematic review. J Shoulder Elbow Surg 2009;18(6):837-44.
32. Aggarwal S, Bali K, Dhillon MS, Kumar V, Mootha AK. Displaced proximal humeral fractures: an Indian experience with locking plates. J Orthop Surg Res 2010;5:60.
33. Agudelo J, Schurmann M, Stahel P, Helwig P, Morgan SJ, Zechel W, et al. Analysis of efficacy and failure in proximal humerus fractures treated with locking plates. Orthopedics 2007;21(10):676–81

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