Long Philos Plate Fixation for Complex Humeral Fractures

Abstract

Background Operative stabilisation of long segment periarticular, periprosthetic and pathological fractures in humerus is a challenging problem. Methods A total of 18 patients were treated by open reduction and internal fixation using the long proximal humeral internal locking system (PHILOS) plate. The types of fractures treated were long segment periarticular fractures extending into the diaphysis (11 of 18), periprosthetic fractures around humeral resurfacing (five of 18) and pathological fractures (two of 18). This study is a retrospective case series review of these cases with a final follow-up observation. The mean follow-up was for 13 months (range 4 months to 48 months). There were 11 women and seven men with a mean age of 52 years (range 19 years to 86 years). Outcomes were assessed using the Constant and Visual Analogue Score. Results There was no incidence of loss of fixation, malunion or a vascular necrosis. The mean time to radiological union was 15 weeks (range 9 weeks to 22 weeks). The mean Constant score for posttraumatic fractures at final review was 76/100 (range 64 to 100). The mean Visual Analogue Score was 0.8 (range 0 to 3). The patients with pathological fractures survived for a mean 5 months (4 to 6 months). Conclusion The long PHILOS plate fixation provides reliable secure fixation for the treatment of complex humeral fractures, especially long segment periarticular fractures, segmental fractures involving proximal humerus and shaft, periprosthetic fractures around well-fixed humeral resurfacing prosthesis and pathological fractures.