Author(s):
Vishnu S., Damodharan, Yeshwanth Subash
Email(s):
djyesh@rediffmail.com
DOI:
10.52711/0974-360X.2022.00419 
Address:
Vishnu S.1, Damodharan2, Yeshwanth Subash3
1,2Department of Orthopaedics, Saveetha Medical College and Hospital, Thandalam, Chennai - 602105, Tamilnadu, India.
3Department of Orthopaedics, Saveetha Medical College and Hospital, Thandalam, Chennai - 602105, Tamilnadu, India.
*Corresponding Author
Published In:
Volume - 15,
Issue - 6,
Year - 2022
ABSTRACT:
Background: Neers 3 and 4 part proximal humerus fractures are often difficult to treat due to the complex nature of the fracture patterns. The aim of this study was to evaluate the functional outcome of these fractures following ORIF (Open reduction and internal fixation) with PHILOS plate. Methods: 30 patients with fractures of the proximal humerus who presented between June 2013 to June 2016 were managed by ORIF with PHILOS plating and were followed up for a period of 3 years. Functional assessment was done using the DASH (Disabilities of arm, shoulder and hand) and Constant and Murley scores. Results: There was a male preponderance seen in our study with the right side being more commonly affected. The mean time to fracture union was 11.9 weeks. The average DASH score at 1 year was 8.9±6.4 and the Constant and Murley score was 64.5±7.2. All patients were satisfied with the functional outcome achieved. Conclusion: PHILOS plating is a good treatment option for complex proximal humerus fractures. It provides multiple divergent screw options for securing purchase in osteoporotic bone and requires less soft tissue stripping and aids in preserving the blood supply to the bone. It provides good union rates and better functional outcomes.
Cite this article:
Vishnu S., Damodharan, Yeshwanth Subash. Evaluation of functional outcome following ORIF of complex proximal humerus fractures with PHILOS plating. Research Journal of Pharmacy and Technology. 2022; 15(6):2508-2. doi: 10.52711/0974-360X.2022.00419
Cite(Electronic):
Vishnu S., Damodharan, Yeshwanth Subash. Evaluation of functional outcome following ORIF of complex proximal humerus fractures with PHILOS plating. Research Journal of Pharmacy and Technology. 2022; 15(6):2508-2. doi: 10.52711/0974-360X.2022.00419 Available on: https://rjptonline.org/AbstractView.aspx?PID=2022-15-6-23
REFERENCES:
1. Baron JA, Barrett JA, Karagas MR. The epidemiology of peripheral fractures [J]. Bone 1996;18(30 Suppl:209S-13.
2. Flatow EL. Fractures of the proximal humerus. In: Bucholz RW, Heckman JD, eds. Rockwood and Greens fractures in adults. Vol. 1. Philadelphia: Lippincott, Williams and Wilkins, 2001:997-1035.
3. Young TB, Wallace WA. Conservative treatment of fractures and fracture-dislocations of the upper end of the humerus. J Bone Joint Surg [Br] 1985;67-B:373-7.
4. Zyto K, Ahrengart L, Sperber A, Tornkvist H. Treatment of displaced proximal humeral fractures in elderly patients. J Bone Joint Surg [Br] 1997;79-B:412-17.
5. Lanting B, MacDermid J, Drosdowech D, et al. Proximal humeral fractures: a systematic review of treatment modalities[J]. J Shoulder Elbow Surg 2008;17(1):42-54.
6. Rees J, Hicks J, Ribbans W. Assessment and management of three- and four-part proximal humeral fractures. Clin Orthop 1998; 353:18-29.
7. Jaberg H, Warner JJ, Jakob RP. Percutaneous stabilization for unstable fractures of the humerus. J Bone Joint Surg [Am] 1992;74-A:508-15.
8. Jakob RP, Miniaci A, Anson PS, et al. Four-part-valgus impacted fractures of the proximal humerus. J Bone Joint Surg [Br] 1991;73-B:295-8.
9. Bjorkenheim JM, Pajarinen J, Savolainen V. Internal fixation of proximal humeral fractures with a locking compression plate: a retrospective evaluation of 72 patients followed for a minimum of 1 year. Acta Orthop Scand 2004; 75:741-5.
10. Koukakis A, Apostolou CD, Taneja T, Korres DS, Amini A. Fixation of proximal humerus fractures using the PHILOS plate: early experience. Clin Orthop 2006; 442:115-20.
11. Kettler M, Biberthaler P, Braunstein V, Zeiler C, Kroetz M, Mutschler W. Treatment of proximal humeral fractures with the PHILOS angular stable plate. Presentation of 225 cases of dislocated fractures. [Article in German] Unfallchirurg 2006; 109:1032-40.
12. Koukakis A, Apostolou CD, Taneja T, Korres DS, Amini A. Fixation of proximal humerus fractures using the PHILOS plate: early experience. Clin Orthop Relat Res 2006;(442):115-20.
13. Moonot P, Ashwood N, Hamlet M. Early results for treatment of three- and four-part fractures of the proximal humerus using the PHILOS plate system. J Bone Joint Surg Br. 2007;89(9):1206-1209. doi:10.1302/0301-620X.89B9.18528.
14. Geiger, Emanuel & Maier, Marcus & Kelm, Arne & Wutzler, Sebastian & Seebach, Caroline & Marzi, Ingo. (2010). Functional outcome and complications following PHILOS plate fixation in proximal humeral fractures. Acta orthopaedica et traumatologica turcica. 44. 1-6. 10.3944/AOTT.2010.2270.
15. Jan-Magnus Björkenheim, Jarkko Pajarinen & Vesa Savolainen (2004) Internal fixation of proximal humeral fractures with a locking compression plateA retrospective evaluation of 72 patients followed for a minimum of 1 year, Acta Orthopaedica Scandinavica, 75:6, 741-745, DOI: 10.1080/00016470410004120