Abstract
Background: Fractures of the proximal humerus account for 5.7% of all fractures, with an incidence rate of 63 cases per thousand adult individuals per year.
Methods: Hospital based Observational study conducted at Trauma center Sardar Patel Medical College, Bikaner. 50 patients were included.
Results: The mean time for radiological union was 9.8 weeks (8- 12 weeks). At the final follow-up, the mean Constant shoulder score was 82. The results were excellent in 28 patients, good in 14 patients, fair in 5 patients and poor in 3 patients. Other complications were not symptomatic enough to undergo additional surgery. No cases of Infection, AVN, hardware failure, locking screw loosening or non-union were noted.
Conclusion: Philos plate provides stable fixation in proximal humerus fractures. Additionally, meticulous surgical dissection to preserve vascularity of humeral head is necessary to prevent potential complications such as AVN.
Keywords: Locking plates, Proximal humerus fracture, Philos.
References
- Geiger EV, Maier M, Kelm A, Wutzler S, Seebach C, Marzi I. Functional outcome and complications following PHILOS plate fi xation in proximal humeral fractures. Acta Orthop Traumatol Turc. 2010;44(1):1-6.
- Baron JA, Barrett JA, Karagas MR. The epidemiology of peripheral fractures. Bone. 1996;18(3):209-13.
- Lanting B, MacDermid J, Drosdowech D, Faber KJ. Proximal humeral fractures: a systematic review of treatment modalities. J Shoulder Elbow Surg. 2008;17(1):42-54.
- Lee SH, Dargent-Molina P, Breart G. Risk factors for fractures of the proximal humerus: results from the EPIDOS prospective study. J Bone Miner Res. 2002;17(5):817-25.
- Nguyen TV, Center JR, Sambrook PN, Eisman JA. Risk factors for proximal humerus, forearm, and wrist fractures in elderly men and women: the Dubbo Osteoporosis Epidemiology Study. Am J Epidemiol. 2001;153(6):587-95.
- Nho SJ, Brophy RH, Barker JU, Cornell CN, MacGillivray JD. Innovations in the management of displaced proximal humerus fractures. J Am Acad Orthop Surg. 2007;15(1):12-26.
- Young TB, Wallace WA. Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus. J Bone Joint Surg Br. 1985;67(3):373-7.
- Park MC, Murthi AM, Roth NS, Blaine TA, Levine WN, Bigliani LU. Two-part and three-part fractures of the proximal humerus treated with suture fixation. J Orthop Trauma. 2003;17(5):319-25.
- Ogiwara N, Aoki M, Okamura K, Fukushima S. Ender nailing for unstable surgical neck fractures of the humerus in elderly patients. Clin Orthop Relat Res. 1996;330:173-80.
- Resch H, Povacz P, Fröhlich R, Wambacher M. Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br. 1997;79(2):295-300
- Robinson CM, Page RS, Hill RM, Sanders DL, Court-Brown CM, Wakefield AE. Primary hemiarthroplasty for treatment of proximal humeral fractures. J Bone Joint Surg Am. 2003;85(7):1215- 23.
- Sadowski C, Riand N, Stern R, Hoffmeyer P. Fixation of fractures of the proximal humerus with the Plant Tan Humerus Fixator Plate: early experience with a new implant. J Shoulder Elbow Surg. 2003;12(2):148-51.
- Fankhauser F, Boldin C, Schippinger G, Haunschmid C, Szyszkowitz R. A new locking plate for unstable fractures of the proximal humerus. Clin Orthop Relat Res. 2005;430:176-81
- Björkenheim JM, Pajarinen J, Savolainen V. Internal fixation of proximal humeral fractures with a locking compression plate: a retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand. 2004;75(6):741-5
- Constant CR, Murley AH. A Clinical method of functional assessment of the shoulder. Clin Orthop Relat Res. 1987;214:160-4.
- Siffri PC, Peindl RD, Coley ER, Norton J, Connor PM, Kellam JF. Biomechanical analysis of blade plate versus locking plate fixation for a proximal humerus fracture: comparison using cadaveric and synthetic humeri. J Orthop Trauma. 2006;20(8):547- 54.
- Seide K, Triebe J, Faschingbauer M, Schulz AP, Püschel K, Mehrtens G, et al. Locked vs. unlocked plate osteosynthesis of the proximal humerus— a biomechanical study. Clin Biomech. 2007;22(2):176-82.
- Walsh S, Reindl R, Harvey E, Berry G, Beckman L, Steffen T. Biomechanical comparison of a unique locking plate versus a standard plate for internal fixation of proximal humerus fractures in a cadaveric model. Clin Biomech. 2006;21(10):1027- 31.
- Papadopoulos P, Karataglis D, Stavridis SI, Petsatodis G, Christodoulou A. Midterm results of internal fixation of proximal humeral fractures with the PHILOS plate. Injury. 2009;40(12):1292-6.
- Gardner MJ, Weil Y, Barker JU, Kelly BT, Helfet DL, Lorich DG. The importance of medial support in locked plating of proximal humerus fractures. J Orthop Trauma. 2007;21(3):185-91.
Corresponding Author
Sanjay Malhotra
Resident, Trauma Center Sardar Patel Medical College Bikaner, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.01
