PHILOS plate fixation in proximal humeral fractures: Functional outcomes

Objectives: The purpose of this study was to evaluate functional outcomes of proximal humerus fractures treated with the PHILOS plate. Methods: Proximal humerus fractures of 24 patients (13males, 11 females; mean age 55 years; range 28 to 83 years) were treated with the PHILOS plate and followed up over a median period of 17 months (range 6 to 36 months) by clinically and radiographically. According to the Neer Classification, 9, 8, and 7 patients had displaced 2-, 3-, or 4-part fractures, respectively. The final follow-up included anteroposterior and lateral x-rays, the Constant Score and the American Shoulder and Elbow Surgeons (ASES) score. Results: At the final follow-up, union was observed in 23 patients (95.8%), 20 fractures (83.3%) healed in good anatomical position by radiographically. However, one patient had hardware failure. There was no evidence of screw penetrated into the joint primarily or secondarily and no evidence of avascular necrosis (AVN) as well as screw cutout at most recent follow-up. Clinical visits and review of medical records showed two patient suffered painful and frozen shoulder. The mean ASES score was 77.8 (range 40 to 95), and the mean Constant Score was 70.8 (range 32.5 to 92). The results were good in 14patients (58.3%), moderate in 8 patient (33.3%), and poor in 2 patients (8.4%).Three complications (12.5%) were seen during the follow-up period. Reoperation was required in 8 patients (33.3%). Conclusion: Our results demonstrate that fixation with the PHILOS plate is a excellent technique with a high union rate and satisfaction rate in the treatment of proximal humeral fractures.