[Early results of treatment of proximal humerus fractures with the PHILOS locking plate].
OBJECTIVE
The aim of this study was to evaluate early results of proximal humerus fractures treated with the PHILOS locking plate.


METHODS
Proximal humerus fractures of 22 patients (13 males, 9 females; mean age 57 years; range 35 to 83 years) were treated with the PHILOS locking plate. According to the Neer classification, 13 patients had comminuted fractures, four patients had valgus impact injuries, two patients had fracture-dislocations, and three patients had fractures involving the proximal 1/3 of the humerus. The fractures were reduced by the transdeltoid lateral approach (n=8) using minimally invasive surgery, and by the anterior deltopectoral approach (n=14) using open surgery. Passive and active exercises were initiated on the second postoperative day and after 4 to 6 weeks, respectively. The results were assessed using the Constant-Murley shoulder scoring system. The mean follow up was 14 months (range 12 to 19 months).


RESULTS
Radiographically, union was observed in 20 patients at the end of 10 weeks. In one patient, time to union was 16 weeks. One patient underwent autogenous bone grafting because of nonunion after 16 weeks. The mean Constant-Murley score was 75.5 (range 51 to 93). There was no significant difference between Constant-Murley scores of patients undergoing the transdeltoid lateral and anterior deltopectoral approaches (p>0.05). Plate fixation was associated with minimal varus deformity in two patients, and subacromial impingement in one patient. Implant failure did not occur. Reflex sympathetic dystrophy and avascular necrosis were observed in two patients, respectively.


CONCLUSIONS
Fixation with the PHILOS plate is a near-ideal technique with a high union rate in the treatment of proximal humeral fractures.
Kiliç
Bülent
B
Başkent Universitesi, Adana Uygulama ve Araştirma Merkezi, Ortopedi ve Travmatoloji Anabilim Dali, Adana. drbulentkilic@hotmail.com
Uysal
Mustafa
M
Cinar
Bekir Murat
BM
Ozkoç
Gürkan
G
Demirörs
Hüseyin
H
Akpinar
Sercan
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology; D018460:Fractures, Comminuted / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D011859:Radiography; D012783:Shoulder Dislocation / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome