Early results for treatment of three- and four-part fractures of the proximal humerus using the PHILOS plate system

Author:

Moonot P.1,Ashwood N.2,Hamlet M.2

Affiliation:

1. South West London Elective Orthopaedic Centre, Dorking Road, Epsom, Surrey, UK.

2. Queens Hospital, Belvedere Road, Burton-on-Trent, UK.

Abstract

Secure fixation of displaced proximal fractures of the humerus is a challenging problem. A total of 32 patients with acutely displaced three- or four-part proximal fractures of the humerus were treated by open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate. There were 23 women and nine men with a mean age of 59.9 years (18 to 87). Data were collected prospectively and the outcomes were assessed using the Constant score. The mean follow-up was for 11 months (3 to 24). In 31 patients (97%) the fracture united clinically and radiologically at a mean of 10 weeks (8 to 24). The mean Constant score at final review was 66.5 (30 to 92). There was no significant difference in outcome when comparing patients aged more than 60 years (18 patients) with those aged less than 60 years (14 patients) (t-test, p = 0.8443). There was one case each of nonunion, malunion and a broken screw in the elderly population. This plate provides an alternative method of fixation for fractures of the proximal humerus. It provides a stable fixation in young patients with good-quality bone sufficient to permit early mobilisation. Failure of the screws to maintain fixation in the elderly remains a problem.

Publisher

British Editorial Society of Bone & Joint Surgery

Subject

Orthopedics and Sports Medicine,Surgery

Reference20 articles.

1. Habermeyer P, Schweiberer L. Fractures of the proximal humerus. Orthopade 1989;18:200–7 (in German).

2. Flatow EL. Fractures of the proximal humerus. In: Bucholz RW, Heckman JD, eds. Rockwood and Greens fractures in adults. Vol. 1. Philadelphia: Lippincott, Williams and Wilkins, 2001:997–1035.

3. Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus

4. TREATMENT OF DISPLACED PROXIMAL HUMERAL FRACTURES IN ELDERLY PATIENTS

5. Assessment and Management of Three- and Four-Part Proximal Humeral Fractures

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