PROXIMAL HUMERUS FRACTURES;

RADIOLOGICAL AND FUNCTIONAL OUTCOME AS TREATED WITH THE PHILOS PLATING SYSTEM, AT A TERTIARY CARE CENTRE IN KARACHI, PAKISTAN.

Abstract

Objectives: The aim of our study is to study the radiological and functional
outcome of proximal humerus fractures treated via open reduction and internal fixation using
the proximal humerus internal locking system or PHILOS. Study Design: Case series study.
Period 05 years duration from January 2011 to December 2015. Setting: Large tertiary care
centre in Karachi, Pakistan. Materials and methods: The study population consisted of n=50
patients all of whom underwent open reduction and internal fixation utilizing the proximal
humeral internal locking system or PHILOS for fractures of the proximal humerus. The inclusion
criterion was all the patients with closed fractures of the proximal humerus and were belonging
to 2,3 and 4 part of the Neer system of classification. Physiotherapy was started as soon as
possible for the patients. Serial radiographic imaging in two views was done at 6, 12, 24 and
52 weeks postoperatively. For the functional outcome of the procedure Constant and Murley
scoring system was used. Data was analyzed using IBM SPSS version 21. Results: The study
population consisted of n= 50 patients of which n= 35 were males and n= 15 were females
having a mean age of 38.50 years. The mean duration of follow up was 24 months. All the
patients in the study had union of fracture both radiographically and clinically, the mean time
duration for the radiographically evident union of the humerus bone was 12 weeks with a range
of 8 to 20 weeks, the mean Constant Murley score for the functional outcome of the shoulder
joint was 79 at the final follow up with a range of 50 to 100. Complications were found in n= 9
patients and varus malunion was the most common complication. In our case series we did not
observe complications such as avascular necrosis, non union or implant failure. Conclusion:
According to the results of our study the proximal humerus internal locking system or PHILOS
is a good method for open reduction and internal fixation of the proximal humerus fractures and
provides a stable fixation, and has lower incidence of complications such as avascular necrosis.