Evaluation of functional outcome following ORIF of complex proximal humerus fractures with PHILOS plating

Abstract

Background: Neers 3 and 4 part proximal humerus fractures are often difficult to treat due to the complex nature of the fracture patterns. The aim of this study was to evaluate the functional outcome of these fractures following ORIF (Open reduction and internal fixation) with PHILOS plate. Methods: 30 patients with fractures of the proximal humerus who presented between June 2013 to June 2016 were managed by ORIF with PHILOS plating and were followed up for a period of 3 years. Functional assessment was done using the DASH (Disabilities of arm, shoulder and hand) and Constant and Murley scores. Results: There was a male preponderance seen in our study with the right side being more commonly affected. The mean time to fracture union was 11.9 weeks. The average DASH score at 1 year was 8.9±6.4 and the Constant and Murley score was 64.5±7.2. All patients were satisfied with the functional outcome achieved. Conclusion: PHILOS plating is a good treatment option for complex proximal humerus fractures. It provides multiple divergent screw options for securing purchase in osteoporotic bone and requires less soft tissue stripping and aids in preserving the blood supply to the bone. It provides good union rates and better functional outcomes.