PHILOS Plate Research Articles

Efficacy of the PHILOS plate in the management and functional outcome of proximal humerus fractures: A prospective study

Proximal humerus fractures management is a challenging task for orthopaedic surgeons due to the high incidence of postoperative complication. PHILOS plate is the recent advancement in locking plate fixation for proximal humerus fractures which provides angular stability and compression that lead to a speedy recovery. The present study was designed to assess the efficacy of the PHILOS plate in the management of displaced fractures to the proximal humerus. A total of 40 cases with displaced proximal humerus fractures admitted in the Department of Orthopedics were recruited. Patients were undergoing Open reduction internal fixation with PHILOS locking plating for the sustained fracture under general anaesthesia. Postoperative follow up appointments were conducted at the end of 2 weeks, 6 weeks, 3 months, 6 months and 12 months. Road traffic accidents were the commonest mode of injury in 72.5% of cases, followed by falling injuries from height (20%) and injuries by falling and slipping (7.5%). The mean constant- murley score was 66.25. The functional outcome was excellent in 20% cases, good in 30% cases, fair in 35% cases and poor in 15% cases. No severe postoperative complications observed. The proximal humerus locking plate is a good treatment option for 2, 3 and 4 part of NEER’s fractures with good functional outcome, good stable fixation with minimal postoperative complications.

EVALUATION OF RESULTS OF PROXIMAL HUMERUS FRACTURE TREATED BY PHILOS PLATTING

Purpose: To assess the functional outcome of proximal humerus fracture treated with Proximal Humerus Internal Locking osteosynthesis (PHILOS) plating. Methods: Functional outcomes of 30 patients aged 30 to 75 (mean 57) years who underwent Philos plate xation for proximal humeral fractures were evaluated after taking informed consent about the study. Indications for surgery were 2-part, 3-part or 4-part closed proximal humeral fractures with angulation of more than 45 degrees or displacement of more than 1 cm. All patients satisfying the inclusion criteria were operated and followed up for 6 months .Functional outcomes and shoulder range of movement were assessed based on the Constant scoring system and was done at 6 months postoperatively. Result: Patients were followed up for 6 months. All fractures healed satisfactorily. No wound infections, vascular injuries, avascular necrosis, or loss of xation ensued. One patients with axillary nerve palsy recovered spontaneously within 3 months. Functional outcome was excellent in 11 patients, good in 15, and moderate in 4. The mean Constant score was 83(range 40–100). Conclusion: Proximal humerus fractures treated by Open Reduction and Internal Fixation by Philos plate have good functional results with low complication rates.

Shoulder function after helical long PHILOS plate.

In order to minimize the risk of damaging the radial nerve while using a long PHILOS plate for proximal humerus fractures, recent studies have proposed twisting the plate in a helical form. This implies a modified surgical approach being yet unclear whether it leads to different middle to long-term shoulder function. This study compares the one-year shoulder functional outcomes of both techniques (helical vs. control). In this retrospective comparative study, we analyzed 30 patients that fit the inclusion criteria, being 14 treated with a helical plate and 16 with a conventional straight long PHILOS plate. The primary endpoint was the normalized constant score after a minimum follow up of one year. Both groups had a good one-year shoulder function, and no significant difference between the normalized constant scores was seen. There was no significant difference in the surgical complications as well. Opting for a helical long PHILOS plate in order to avoid radial nerve damage provided a safe treatment with similarly good one-year shoulder function compared to straight PHILOS plates. Level 3, Retrospective Cohort Study.

A prospective study of outcome of fracture of proximal humerus treated with PHILOS plating

Background: PHILOS plating is used for two to four fragmented dislocated fractures of the proximal humerus, including fractures involving osteopenic bone, pseudarthroses and osteotomies in the proximal humerus. Various studies have been conducted regarding outcome of fracture of proximal humerus treated with PHILOS plating with variable outcome. Present study was designed to determine the efficacy and functional outcome of PHILOS locking plate in proximal humerus fractures.Method: As per study criteria 40 patients with fracture of shoulder was included in this study. After admission of patients a detailed careful history was taken to know the mechanism of injury. Patient was assessed clinically to evaluate general condition, vitals were recorded and examination o fracture site was done to know the Swelling, deformity, loss of function and nerve injury, distal vascularity. Radiological assessment was done and fracture was classified and preoperative routine haematological investigation was done.Result: Regarding complications of surgery postoperative infection was found in 2(5%) patients, stiffness of shoulder was present in 2(5%) patients, one patients developed malunion and Osteonecrosis was present in one patients. Constant score was excellent in 20 (50%) patients; it was good in 18(45%) patients and fair in 2(5%) patients.Discussion and conclusion: From present study we can conclude that PHILOS platting provides good fracture stabilization in the treatment of proximal humeral fractures. Stiffness of shoulder was common complication but present in 5% patients. Postoperative outcome was excellent in most of the patients.

MutiLoc Nail Versus Philos Plate in Treating Proximal Humeral Fractures: A Retrospective Study Among the Alderly.

BackgroundProximal humeral fractures (PHFs) account for 4–5% of all fractures in the elderly. There is still a controversy among the treatments in the displaced PHFs. Our aim was to explore the clinical outcome of PHFs with the treatment of MultiLoc nail or Philos plate in the elderly patients.MethodsA total of 82 sustained elderly patients with PHFs were finally recruited between Dec 2016 and Dec 2017. 34 patients were treated with MultiLoc nail and 48 patients were treated with Philos plate. The demographics, fracture types, blood loss, operation time, union time, postoperative complications, visual analog scores (VASs), Constant scores, American Shoulder and Elbow Scores (ASESs), and neck-shaft-angle (NSA) between the two groups were compared.ResultsNo differences were observed in the demographics, fracture types, VAS, Constant scores, and ASES scores between the two groups at final follow-up. Compared with the plate group, the blood loss, operation time, and union time were significantly lower in the nail group (all P < .05). The rate of general complications was 54.17% in the plate group, which was higher than that in the nail group (26.47%, P = .01). Three patients experienced reoperation in the plate group (3/48; 6.25%), but none in the nail group. Although there were no significant differences in intraoperative NSA between the two groups, the NSA at final follow-up in the nail group was much higher than the plate group (137.55 ± 5.53°vs 134.47 ± 5.92°, P = .02).ConclusionsMultiloc intramedullary nail showed the similar effectiveness of final VAS, final Constant scores, and ASES scores in PHFs treatment with Philos plate. However, MultiLoc nail is superior to Philos plate in blood loss, operation time, complications, reoperation rate, and the change of NSA.

Functional outcome of operative vs conservative management of 4 part proximal humerus fracture: A prospective comparative study

Background: Proximal humerus fractures are most common injuries involving the shoulder next to clavicle. Most of the injuries are due to high energy impact occurring during RTA, fall from height, fall due to convulsion or epilepsy. Fractures are associated with sever commination and collapse of articular surface leading to dislocation and severe pain, swelling. Generally, these Neers 4-part fractures are managed by surgery with PHILOS plate. However, in our study of 15 patients managed conservatively showed better results compared to patients managed operatively with PHILOS. Methods: This is a prospective interventional study of 30 cohort cases of proximal humerus fracture – Neers 4 part. Patients willing for operations are treated with PHILOS and those non-willing and who were not fit for surgery were managed conservatively with sling. Early rehabilitation and pendulum exercises started at the beginning of 2-week post op. Patients were admitted and followed at our institution from 2015 t0 2017. Outcome analysed at the end taking into consideration of clinical and radiological improvements. Functional outcome will be assessed by Constant Murley score at the end of study. Results: In our series of 30 patients, majority of the patients were males, with RTA and fall from height in field being the commonest mode of injury in young population and domestic fall being the most common mode of injury in elderly. Fractures managed conservatively showed good range of shoulder movements with less complications compared to operated cases. However early mobilisation and pain management were seeming to be well with PHILOS in immediate post-operative days but shoulder strength and long-term pain controlled better in non-operative cases. Majority of the fractures united with a good to moderate outcome in 50% of the patients. Malunions were the only complications in non-operative cases and in PHILOS there were some incidences of screw perforation, AVN, plate impingement and infection along with malunion. Conclusions: though many studies conclude Proximal Humerus locking compression plate is an advantageous implant because of its angular stability, particularly in communited osteoporotic bones in elderly patients, thus allowing early mobilization. It has many complications. In our study non operated Neers 4-part proximal humerus fractures did well at the end of study without suffering any complications. In fact, non-operated group was more confident in shoulder movements during physiotherapy. Hence, it’s better to manage these fractures conservatively.

Management of fibrous dysplasia of the femur neck in a child by PHILOS Stabilization, curettage, and bone grafting: A case report

Fibrous dysplasia has a considerable risk of pathological fractures particularly in proximal femur in younger age group. These are challenging to treat, especially in pediatric population. Several treatment modalities have been proposed, each having its own pros and cons. Attention should be given in pediatric population in choosing technique and selection of implants to preserve growth of the limb and to prevent implant prominence and soft tissue irritation. We are reporting a case of pathological neck of femur fracture secondary to fibrous dysplasia, in an 11-year-old obese boy, managed with curettage, iliac crest bone grafting and osteosynthesis with PHILOS plate (a plate routinely used in adults for humerus neck fractures). At 6 months follow-up, he shows a good consolidation of iliac crest graft at fracture site with stable implant and an excellent functional outcome in terms of pain and range of motion, without any radiological sign of recurrence.

A comparative study of surgical management of surgical neck of humerus fracture in adults by proximal humeral nailing and PHILOS

Fractures of surgical neck of the humerus represent 25% of the proximal part of humerus. Neer described three types of fracture of the surgical neck: angled, translated/separated and comminuted. Proximal humeral nail and PHILOS plate fixation for the surgical neck of humeral fractures offers good anatomic fracture reduction and stable primary fixation to ensure rapid fracture healing and imme­diate post-operative functional therapy without prolonged immobilization. Objective: To assess and compare the functional outcome and the fracture union of surgical neck of humerus fractures using proximal humeral nail and PHILOS plate. Material and Method: Prospective Comparative study was conducted at Bapuji and Chigateri General hospital attached to JJM Medical college, Davangere for a period of two years from July2018 to July 2020.60 adult patients with surgical neck of humerus fractures who were willing for surgery were admitted during the period of study and followed up for 12 months. Result: In our study most patients were Female (60%) out of 60 patient. The mean age being 58 years in Group1 and 47.66 years in Group 2. Most of the case were road traffic accident comprising of 65% in Group 1 and self fall 63% in Group 2. In this study,70% of the patients presented with 2-part fracture, 30% with 3-part fracture in Group 1 and 50% of each fracture pattern in Group 2. In this study, according to Neer’s score of patients had excellent 9(30%), satisfactory outcome 17(56.66%), and unsatisfactory outcome 4(13.33%) in Group 1 patients and, excellent result in 6(20%) cases, 20 cases (66.66%) had satisfactory outcome and unsatisfactory outcome 4(13.33%) in Group 2. Conclusion: Surgical neck of humerus treated with PHN offers minimally invasive, cosmetically acceptable scar, stable and axial fixation with minimal soft tissue damage, early mobilization, where as in PHILOS provide rigid and stable fixation in most of communited fractures.

Functional outcome of different treatment modalities of proximal humerus fracture (3 part and 4 part)

Introduction: Proximal humerus fracture is the most common fracture of humerus consisting 45% of all humerus fracture and second most common fracture in upper extremity. Diagnosis and proper management of proximal humerus fracture is important as the shoulder joint needs a high demanding function for daily activities. Various treatment options available for proximal humerus fracture from conservative management, K wire fixation, ORIF and plating, hemiarthroplasty to Reverse Shoulder arthroplasty.Aims and Objective: Our study aimed to evaluate the one year follow up results of different treatment modalities in a perspective series of proximal humerus fracture and study complication, if any involved with these modalities and to find out the basis of selecting the mode of treatment of proximal humerus fracture to bring out the best functional outcome.Materials and Method: 40 patients with displaced proximal humerus fracture (3 part and 4 part) treated between September 2018 to August 2019 were included in this study. Out of 40 patients in our study 32 patients have 3 part and 8 patients have 4 part fracture. 33 patients (3 part-27, 4 part-6) treated with PHILOS plating. 3 patients (All 3 part) treated with K wire fixation. 2 patients (All 3 part) treated conservatively. 2 patients (All 4 part) treated by Reverse Shoulder Arthroplasty. The functional outcome has been assessed by Constant-Murley shoulder scoring system.Results: Out of 40 cases 10(25%) patients had excellent result, 21(52.5%) good, 8(20%) moderate and 1 (2.5%) patient show poor outcome. There are few complications in our study-Malunion (3 patients), nonunion (2 patients), Joint stiffness (1 patient), Instability (1 patient), Heterotropic Ossification (1 patient), AVN of humeral head (2 patients).Conclusion: From this study we found that PHILOS is an effective treatment for 3 part fracture and for 4 part fracture Reverse Shoulder Arthroplasty is appears to be better option.

Non Vascularised Fibula Strut Graft Augmentation for Fixation of Proximal Humerus 3-Part Fracture using PHILOS Plate and CC Screws in a Young Male

Proximal humerus fracture accounts for 4-5% of all fractures. Locking Compression Plate (LCP) Proximal Humerus Internal Locking System (PHILOS) fixation is currently the most widely used method for the management of unstable proximal humerus fractures. LCP system of the proximal humerus is better than other available implants because of better anatomic design, fixed angulated configuration of locking screws, rotational and angular stability. This case report was of a 35-year-old male who presented with pain, swelling and difficulty in movement at the right shoulder, after a road traffic accident. Plain radiograph of right shoulder (anteroposterior) view revealed displaced 3-part proximal humerus fracture (humeral head with lesser tuberosity, greater tuberosity and shaft). It was managed with philos plate, Cannulated Compression (CC) Screws and non vascularised fibular strut graft. At two years follow-up, patient showed good shoulder range of motion with no complication.

The results of open reduction and plate fixation with angular stability of the proximal humerus fractures in patients with osteoporosis

Objective: a retrospective study of anatomical and functional results of open reduction and plate osteosynthesis in patients older than 50 years with of the proximal humerus fractures type AO/OTA 11-B, 11-C and osteoporosis, who were treated with plate PHILOS taking into account the surgical treatment of adverse results with reverse total shoulder arthroplasty (RTSA). Methods: we analyzed case histories of 58 patients (age older 50 years) with osteoporosis and three- and four-fragment fractures of the proximal umerus according to the Neer classification (type AO/OTA 11-B, 11-C). In group I — 20 patients (age from 50 to 76 years, 8 men and 12 women) — we made open reduction, ORIF with plate PHILOS; II — 38 patients (aged 54 to 78 years, all women) — had surgeries ORIF with PHILOS plate and 3D polylactide implants. Results: according to the Constant Murley Shoulder Score system in 11 (55 %) patients of group I excellent and good results were obtained, in 5 (25 %) — satisfactory, in 4 cases (20%) are unsatisfactory. At the last cases we made RTSA in terms from 6 to 12 months after the primary surgery, one of them had revision RTSA due to fracture of the humeral shaft and instability of the stem implant. According to the Constant Murley Shoulder Score system, the average score after 12 months in group I was 78, in II — 87. No signs of avascular necrosis of the humeral head were observed. Conclusions: the use of PHILOS plates with additional reinforcement with 3D polylactide implants allowed us to obtain positive results in 34 (89.5 %) patients after 6–12 months after the surgery with a lower complications rate compare to known techniques. If ORIF method gives an unfavorable result then RTSA gives the possibility to achieve positive results within 3 years after the surgery.

Functional outcome of patients treated with proximal humeral internal locking osteosynthesis plate in proximal humeral fractures

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Displaced or unstable proximal humeral fractures fare poorly with non-operative treatment. These are better treated with surgical intervention in order to prevent minimal displacement of tuberosity or articular surface from compromising the long term articular function. The objective was to assess the functional outcome of patients treated with PHILOS (the proximal humeral internal locking osteosynthesis) plate in proximal humerus fracture.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 42 patients age group range between 20 and 80 years 61.9% are male and 38.1% are female treated with philos plate. Functional outcome measured by using Constant and Murley score.&lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 50% were Neer two part fractures, 35.7%, three part fractures, 14.3%, four part fractures. After 6 month follow up functional outcome assessed by using constant and Murley score. Excellent outcome in 1 (2.4%) good outcome in 13 (31%), fair outcome in 19 (45.2%) and poor outcome in 9 (21.4%) noted.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; PHILOS plate fixation of proximal humerus fracture is an effective surgical technique in maintaining stability of fractures and there is significant improvement in functional outcome.&lt;/p&gt;

Dynamic locking screws in proximal humeral plate osteosynthesis demonstrate superior fixation properties: a biomechanical study

PurposeAngular stable implants reduced the complication rate in the treatment of humeral head fractures. But the failure rate is still high. To further reduce the risk of cut-out, cement augmentation of screws was introduced. A reason for failure of plate osteosynthesis might be the extremely high stiffness of the screw-plate interface leading to a loss of reduction and cut-out of screws. A more homogeneous distribution of the forces on all screws may avoid secondary dislocation. We hypothesize that dynamic osteosynthesis minimizes screw loosening and results in a higher load to failure than standard locking screws.MethodsTwelve paired human humerus specimens were analysed. A standardized three-part fracture model with a metaphyseal defect was simulated. Within each pair of humeri, one was fixed with a Philos plate and standard locking screws (LS), whereas the other humerus was fixed with a Philos plate and dynamic locking screws (DLS). A cyclic varus-bending test or a rotation test with increasing loading force was performed until failure of the screw-bone-fixation.ResultsIn the varus bending test, pairs failed by screw loosening in the humeral head. The LS-group reached 2901 (601–5201) load cycles until failure, while the DLS-group failed after 3731 (2001–5601) cycles. This corresponds to a median loading of 195 N for the LS-group and 235 N for the DLS-group (p = 0.028). In the rotation test the LS-group reached a median of 1101 (501–1501) load cycles until failure of fixation occurred, while the DLS-group failed after 1401 (401–2201) cycles (p = 0.225).ConclusionsPlate fixation using dynamic locking screws for the treatment of proximal humerus fractures demonstrated more load cycles until failure compared to standard locking plate osteosynthesis.

Functional outcome of proximal humerus fracture treated conservatively Vs PHILOS plate

Aim and Objective: Fracture of the proximal humerus, part 2, 3 and 4 have been a challenge to achieve stable fixation .The goal is to achieve near anatomical reduction, preserve biology, stabilization and achieve early mobilization. PHILOS plate provide rigid fixation, more angular stability and good union rate. In this study we have assessed the functional outcome of patients who have undergone PHILOS plating for proximal humerus fracture vs the patient treated conservatively. Material and method: Study was conducted in department of orthopaedics, Rajah Muthiah Medical College and Hospital. Total of 20 patient with fracture of proximal humerus was observed with 10 patient treated using PHILOS plate and 10 patient treated conservatively. Open reduction and internal fixation was performed in 10 patients and in 10 patient u-slab was applied. Result were assessed by constant and murley shoulder outcome score Result: The average follow up time was 6 months. Results were analysed in respect to union of fracture, range of motion of shoulder joint. The mean union time was 8 weeks. Conclusion: PHILOS plating is effective in treatment of proximal humerus fracture with high rate of bony union and early mobilization with excellent clinical and radiological outcome.

Functional outcome of proximal humerus fracture using PHILOS plating

Aim and Objective: Fracture of the proximal humerus, part 2, 3 and 4 have been a challenge to achieve stable fixation .The goal is to achieve near anatomical reduction, preserve biology, stabilization and achieve early mobilization. PHILOS plate provide rigid fixation, more angular stability and good union rate. In this study we have assessed the functional outcome of patients who have undergone PHILOS plating for proximal humerus fracture.Material and Method: Study was conducted in department of orthopaedics, Rajah Muthiah Medical College and Hospital. Total of 20 patient with fracture of proximal humerus treated using PHILOS plate. Open reduction and internal fixation was performed in 20 patients. Result were assessed by constant and murley shoulder outcome score Result: The average follow up time was 6 months. Results were analysed in respect to union of fracture, range of motion of shoulder joint. The mean union time was 8 weeks. Conclusion: PHILOS plating is effective in treatment of proximal humerus fracture with high rate of bony union and early mobilization with excellent clinical and radiological outcome.

A study of prospective analysis of outcome of proximal humerus fracture with philos plate fixation

Introduction: Proximal humerus fractures constitute 5% of all fractures. These fractures are common in elderly patients presenting as a challenging problem in the management because of the low-quality of cancellous bone. Aim: The study aims to evaluate the outcome of proximal humerus fractures managed with PHILOS. Methods: This prospective study to determine the outcome of proximal humerus fractures treated with PHILOS. 40 patients were taken for this study. Preoperative workup was done to exclude open fractures. Majority of fracture fixation was done through a deltopectoral approach. Fracture fixation was done with the PHILOS plate under ‘C’ armcontrol. All patients were reviewed clinically and radiologically at regular interval. Results: Type of fractures according to Neer’s classification 22 were two parts, 8 three parts and 10 four parts. Excellent results were in 26 cases, good results in 9 cases, fair results in 5 patients and there were no poor results. Fair results were in four parts fractures with intraarticular extensions. Conclusion: PHILOS fixation gives excellent results in proximal humerus fractures, and it provides rigid fixation in early mobilization. However, we are aware that this is a short term study and would require further evaluation and more input.

Locking blade nail in proximal humeral fractures

Objective.&nbsp;Locking blade nail (LBN) represents a new technique that arises from better knowledge of the critical factors that stabilize a proximal humerus fracture. After 3 years of LBN practice, we examined outcomes achieved with the LBN technique compared to the previous prevailing use of plating and screw. Methods:&nbsp;Over 7 years, 332 patients with 2-3-4 part fractures (Neer Classification) were surgically treated. We created 2 groups: A (n = 104) treated with intramedullary LBN nail and B (n = 104) treated with a Philos plate. VAS, SF-36 Scale and Constant Score (CS) were assessed at 1, 3 and 6 months after surgery. Results.&nbsp;Active range of motion and CS showed no significant difference between the two groups for patients with less than 75 years (p &gt; 0.05). In 4-part fractures and elderly patients (&gt; 75 years), LBN showed better results in terms of active range of motion and pain. Six months after surgery, 84.6% (group A) and 73% of patients (group B) had a CS &gt; 80 points and no patient showed persistence of pain (VAS scale). Conclusions.&nbsp;In our experience, use of LBN has led to satisfactory results and a very few cases of complications, even if surgery was performed by different surgeons and on a population that differed in age, comorbidities and severity of humeral fracture.

Comminuted Displaced Fractures of Surgical Neck of Humerus Treated by PHILOS Plating

Comminuted Displaced Fractures of Surgical Neck of Humerus Treated by PHILOS Plating

Outcome of proximal humeral fracture fixation with K wires Vs Philos plating

Introduction- Proximal humerus fractures represent one of the most common fracture type in upper extremity. Aim- this study aimed to see outcome of proximal humeral fracture fixation with K wires vs PHILOS plating Material and Method- A prospective study was conducted overthree years of a total of 50 patients with proximal humerus fracture. Patients were divided into two groups by randomized controlled trial .Group 1 included 25 patients who were treated with closed reduction and percutaneous k wire fixation. Group 2 included 25 patients who were treated with ORIF with PHILOS plate .All these 50 patients were followed up for mean duration of 12 months Results- Mean neer score at final follow up was 80 in group 1 patients while it was 90 in group 2 patients As per the Neers scoring system ; 7 patients (28%) in group 1 had excellent results ,12 patients(48%)had satisfactory Results,2 patients( 8%) had unsatisfactory results while 4 patients (16%) had poor outcome For Group 2 ,as per Neers scoring system 12 patients (48%) had excellent results,9 patients (36%) had satisfactory results, 2 patients (8%) had unsatisfactory results while 2 patients (8%) had poor outcome. Conclusion-In conclusion it was found that K-wires fixation for proximal humerus fractures type III and type IV (Neer’s) gives inferior results than proximal humerus interlocking system (PHILOS) Keywords: K-wire, proximalhumerus interlocking system Neer’s Score,

Treatment options for proximal humeral fractures in the older adults and their implication on personal independence.

No consensus exists on the optimal treatment of proximal humeral fractures (PHFx). Uncertainty about surgical treatment in the older adults using locking plates (e.g., PHILOS) has emerged, due to a high number of complications. This study aimed to assess the impact of non-operative versus operative treatment of a PHFx on the level of self-dependence in our older population. We included patients aged over 65years with some level of self-dependence, treated at our hospital between 5/2011 and 4/2013 for isolated PHFx of AO subtypes A2, A3, and B1 for which either non-operative or surgical treatment using a PHILOS plate had been applied. The patients were questioned, examined, or interviewed via phone; AO fracture patterns and treatment were documented as well as level of self-dependence, complications, constant score (CSM), subjective shoulder value (SSV), quality of life (EQ-5D), and shoulder pain and disability index (SPADI). Patients with PHFx of AO subtypes A2, A3, or B1 that were either treated non-operative (n = 50) or operative by insertion of the PHILOS plate (n = 63) were included. Operative-treated patients were 3.3 times as likely to lose some level of independence (95% CI 0.39-28, p = 0.271). Shoulder motion, strength, and functional outcomes tended to be lower in operative-treated patients, with adjusted differences of, - 11 CMS points (95% CI - 23 to 2), - 9 SPADI points (95% CI - 18 to 0), and - 6% in SSV (95% CI - 17 to 5). Quality-of-life EQ-5D utility index was similar in both groups (mean - 0.04; 95% CI - 0.18 to 0.10). In our study population, non-operatively treated older adults with an AO type A2, A3, B1 fracture of the proximal humerus tended to have a high chance to return to their premorbid level of independence, compared to patients treated with a locking plate. A change in the treatment algorithm for these PHFx may be carefully considered and further investigated in clinical practice.