PHILOS Plate Plus Oblique Insertion of Autologous Fibula for 2-Part Proximal Humerus Fractures With Medial Column Disruption: A Retrospective Study

Author:

Shu Ying12,Chen Meiji32,Yu Weiguang4ORCID,Ge Zhe5,Hu Hao1,Zhang Xinchao5ORCID,Zeng Xianshang4,Liu Xiangzhen6

Affiliation:

1. Department of Anesthesiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, Wuhan, China

2. *  Ying Shu and Meiji Chen contributed equally to this work.

3. Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China

4. Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China

5. Department of Orthopaedics, Jinshan Hospital, Fudan University, Jinshan District, Shanghai, China

6. Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China

Abstract

Introduction: The aim of this retrospective study was to evaluate the outcomes of older patients with 2-part proximal humerus fractures (PHFs) with medial column disruption stabilized using a proximal humeral internal locking system (PHILOS) plate plus oblique insertion of autologous fibula as a primary procedure. Materials and Methods: Data involving 112 patients (112 shoulders) sustaining 2-part PHFs with medial column disruption treated with PHILOS plate plus oblique insertion of autologous fibula as a primary procedure during 2012-2019 were identified. The median follow-up was 36 months (range: 11.2-43.5 months). The primary endpoint was the Constant scores and American Shoulder and Elbow Surgeons (ASES) scores. The secondary endpoint was the main orthopedic complication rate. Results: The median Constant and ASES scores were 78 (range, 52-95) and 77 (range, 62-96) at the final follow-up, respectively. The main orthopedic complication rate was 10.7% (12/112). Twelve orthopedic complications in 8 patients were detected, and they involved loss of reduction, varus collapse, aseptic loosening, mal-union, revision, and intolerable shoulder pain. Of these complications, 3 (2.6%) involved loss of reduction, 2 (1.7%) involved varus collapse, 3 (2.6%) involved aseptic loosening, 1 (0.8%) involved mal-union, 2 (1.7%) required revision surgery, and 1 (0.8%) presented intolerable shoulder pain. Conclusion: PHILOS plate plus oblique insertion of autologous fibula as a primary procedure may yield good functional outcomes and a low rate of the main orthopedic complications.

Publisher

SAGE Publications

Subject

Geriatrics and Gerontology,Rehabilitation,Orthopedics and Sports Medicine,Surgery

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