TREATMENT OF PROXIMAL HUMERUS FRACTURES USING PHILOS PLATE: A RETROSPECTIVE REVIEW OF RECORDS IN A TERTIARY CENTER IN NEPAL

Abstract

Introduction Treatment of proximal humerus fractures always holds a dilemma for the treating surgeon. Many treatment options are available for its management. This retrospective review of records aimed to assess the functional outcome of proximal humerus fractures treated with Proximal Humerus Internal Locking System (PHILOS) plating. Fifty-three consecutive patie Material and Methods nts were treated with PHILOS plating between August 2019 to August 2021. Adults 18-65 years with displaced closed fracture proximal humerus (displacement >1 cm and varus angulation of >45) who underwent xation with PHILOS plate were included in this study. Severely comminuted fractures, open fractures and valgus impacted fractures were excluded from the study. Patients with additional injuries to ipsilateral limb and other systems were also excluded. Neer's scoring system was recorded for visit at 3,6 and 12 weeks The average Results age was 54.3±5.8 years. As per the Neers classication system, there were 6 (11.32%) 1-part, 19 (35.85%) 2-part, 17 (32.085) and 11 (20.75%) 3 and 4-part fracture respectively. Average surgical duration was 94±10.2 minutes. Radiological union was seen at 12±4.6 weeks. There were 2 (3.77%) cases of varus collapse. Three (5.66%) cases had screw back out, which was later revised and had a favorable outcome. As per the Neer's scoring system, 7 (13.21%) cases had excellent results, 37 (69.81%) had satisfactory, 6 (11.32%) had unsatisfactory while 3 (05.66%) cases had poor outcomes. PHILOS plating has a good Conclusion functional outcome. However, proper patient selection, thorough knowledge of the anatomy and biomechanical principles are the pre-requisites for a successful surgery.