Mid-term results of internal fixation of proximal humeral fractures with the Philos plate.
OBJECTIVE
To report our experience from the use of the Philos plate for the treatment of three- and four-part proximal humeral fractures and to investigate factors influencing the final outcome.


METHODS
Between April 2005 and September 2007, 29 Philos plates were implanted in 17 women and 12 men, with a mean age of 62.3 years (range: 28-80 years). Positioning of the plate was performed under fluoroscopic control, through a deltopectoral approach and with the patient in the beach chair position. 27 patients were available for follow-up (mean: 17.9 months; range: 12-39). Follow-up included plain shoulder radiographs and functional assessment with Constant-Murley score.


RESULTS
Healing of the fracture occurred uneventfully within 6 months. In three patients, humeral head collapsed due to aseptic necrosis after fracture healing and the plate had to be removed in two cases. In one patient, fracture healing occurred in >10 degrees varus displacement. The clinical result according to the Constant-Murley score was 86 points (range: 58-112).


CONCLUSIONS
Internal fixation with the Philos plate seems to be a reliable option in the operative treatment of upper end humeral fractures, especially in osteoporotic bone. It allows secure fracture fixation and quick shoulder mobilisation, while quick and uneventful fracture healing and very satisfactory clinical results are achieved.
Papadopoulos
Periklis
P
1st Orthopaedic Department of Aristotle University of Thessaloniki, G. Papanikolaou General Hospital, 57010 Exohi, Thessaloniki, Greece.
Karataglis
Dimitrios
D
Stavridis
Stavros I
SI
Petsatodis
George
G
Christodoulou
Anastasios
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D017102:Fracture Healing / Q000502:physiology*; D006801:Humans; D006811:Humerus / Q000098:blood supply / Q000473:pathology; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology / Q000209:etiology; D010024:Osteoporosis / Q000150:complications; D011859:Radiography; D016059:Range of Motion, Articular; D012784:Shoulder Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D016896:Treatment Outcome