title: Minimal Invasive Percutaneous Osteosynthesis for Elderly Valgus Impacted Proximal Humeral Fractures with the PHILOS.
abstract: There is a growing concern about elderly valgus impacted proximal humeral fractures. The aim of this study was to evaluate the treatment and clinical outcomes following minimal invasive percutaneous plate osteosynthesis (MIPPO) with the proximal humeral internal locking system (PHILOS) for the treatment of elderly valgus impacted proximal humeral fracture. Between May 2008 and May 2012, 27 patients (average age 67.3, range 61-74) with valgus impacted proximal humeral fractures were enrolled in the study. The patients were treated with MIPPO using PHILOS-plate through the anterolateral delta-splitting approach. Rehabilitation exercises were done gradually. The NEER score and Constant-Murley score were used to evaluate shoulder function. All the patients were followed up by routine radiological imaging and clinical examination. There were 15 cases of II-part greater tuberosity fractures, 10 cases of III-part greater tuberosity fractures, and 2 cases of IV-part fractures according to the NEER classification. The surgery was successful in all patients with an average follow-up of 20.8 (range: 11-34) months. The fractures united in an average of 7.2 (6-14) weeks without implant loosening. According to NEER score, there were 17 excellent, 7 satisfactory, 2 unsatisfactory, and 1 poor. The mean Constant-Murley score was 89.4 ± 4.35. No complication including axillary nerve damage, postoperative nerve or vessel damage, infections, DVT, or death was observed. In conclusion, the MIPPO technique with the PHILOS through the anterolateral delta-splitting approach seems to be a safe and easy treatment for elderly valgus impacted proximal humeral fractures. A case-control study and longer follow-up time are needed.
authors.affiliation: Sichuan Orthopaedic Hospital, No. 132 Yihuan Road, Chengdu, Sichuan 610041, China.
authors.forename: Hang
authors.initials: H
authors.lastname: Chen
authors.affiliation: Sichuan Orthopaedic Hospital, No. 132 Yihuan Road, Chengdu, Sichuan 610041, China.
authors.forename: Xiaochuan
authors.initials: X
authors.lastname: Hu
authors.affiliation: Sichuan Orthopaedic Hospital, No. 132 Yihuan Road, Chengdu, Sichuan 610041, China.
authors.forename: Haochen
authors.initials: H
authors.lastname: Tang
authors.affiliation: Sichuan Orthopaedic Hospital, No. 132 Yihuan Road, Chengdu, Sichuan 610041, China.
authors.forename: Guoyong
authors.initials: G
authors.lastname: Yang
authors.affiliation: Sichuan Orthopaedic Hospital, No. 132 Yihuan Road, Chengdu, Sichuan 610041, China.
authors.forename: Ming
authors.initials: M
authors.lastname: Xiang
mesh_terms: D000368:Aged; D060906:Coxa Valga / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D004838:Epiphyses / Q000473:pathology / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D011859:Radiography; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome