Introduction
The objective of this study was to evaluate the functional and radiological outcome after open reduction and internal fixation of proximal humeral fractures with the proximal humeral internal locking system (PHILOS) plate.
Patients and methods
This prospective case series included 30 patients. All cases were managed by open reduction of the fractures and internal fixation by the PHILOS plate. The inclusion criteria included patients with displaced two, three, and four-part fractures. Six (20%) patients had two-part fractures, 12 (40%) had three-part fractures, 12 (40%) had four-part fractures. There were 18 male patients and 12 female patients. The mean patient age was 49 years (22–74 years). The average follow-up period was 9 months (6–12 months). The functional outcome was assessed using the constant score at 6 months. Radiological evaluation was carried out immediately postoperatively, at 6 weeks, 3 months, 6 months, and 1 year.
Results
Most of the series patients had a satisfactory outcome. The mean constant score was 72.4 points (range, 46–94 points) at 6 months’ follow up. Healing of the fracture occurred uneventfully in 83.4%. However, some complications were found in this patient series. In two (6.6%) patients, the humeral head collapsed due to avascular necrosis after fracture healing. In one (3.3%) patient, fracture healing occurred with varus displacement, but the patient was satisfied with the outcome. No implant failure and no delayed union or nonunion was noted.
Discussion and conclusion
Management of proximal humeral fractures with PHILOS plates achieves a good reduction and satisfactory clinical and radiological outcomes; however, some complications might be expected in some patients.