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

Abstract

Objective To evaluate the clinical results of open reduction and internal fixation of valgus impacted four-part proximal humerus fractures with the AO proximal humeral internal locking system (PHILOS). Methods Eleven patients (mean age 42 years) with four-part valgus impacted fracture of the proximal humerus underwent operations. The exposure was limited tothe lateral side of the intertubercular sulcus and the periosteal continuity of the lesser tubercle was preserved. When the humeral head was reduced, autograft or allograft bone was implanted to the site of bone defects, and subsequently the PHILOS plate was used to fix the fractured bone. Results All cases were followed up 20 months after the surgery. Avascular necrosis of the humeral head was found in one case. The necrosis ratio was 9.1%. The mean angle of anterior flexion of the shoulder was 150°. The mean angles of external and internal rotation of the shoulder were 20° and Thl2, respectively. The mean JOA score was 91. Conclusion Open reduction and internal fixation with PHILOS locking plate can gain satisfactory therapeutic effects in the treatment of valgus impacted four-part proximal humerus fractures. Key words: Humerus; Fractures, bone; Treatment outcome; PHILOS plate