Functional and Radiological Outcome with Associated Post-Operative Complications in Management of Proximal Humerus Fracture Using Proximal Humeral Internal Locking System(PHILOS)

Abstract

Background: A proximal humeral fracture is the fracture of the ball portion, lying at the
upper end of the humerus, or arm bone. These are one of the commonest fractures
encountered by orthopaedic surgeons. Some studies suggest that the locking plate (PHILOS)
provides good fracture stability and allows early mobilization of the shoulder without
compromising fracture union. Use of PHILOS plate as a surgical option in the management
of proximal humerus fracture has been recommended. Methodology- The study was
conducted on patients presenting with proximal humerus fractures admitted to Basaveshwar
Teaching and General Hospital, Kalaburagi for a period of 18 months.30 patients fulfilling
the inclusion and exclusion criteria were considered for this study. All patients were operated
using standard deltopectoral approach. Post op functional outcome was assessed by using
Neer’s scoring system. Results- Majority were right handed persons and the dominant arm
was involved in 22(73.34%) patients and 8(26.66%) were left handed patient. Neer’s 2-part
fracture is the most common type in 60% patients. Greater Tuberosity fractures were the
predominant type in 2-part fracture.4 part fractures accounted for only 10% of patients.
18(60%) patients did not have any pain during follow-up. No cases of implant loosening or
failure were encountered. Conclusion- Displaced proximal humeral fractures when treated
surgically produce greater range of movements (ROM), less pain and less stiffness. Results
are best when operative method results in stable fixation that allows early passive
mobilization