title: The treatment of complex proximal humeral fractures: analysis of the results of 55 cases treated with PHILOS plate.
abstract: Complex proximal humerus fractures are often difficult to treat. Their frequency is high, especially in the elderly, and their treatment is still controversial. The aim of this study was to analyze the clinical and radiological results achieved by patients with complex proximal humerus fractures, treated with PHILOS plate only. A cohort of 55 patients was selected. The mean age was 63.4 (range 33-89), while the mean follow-up time was 21.5 months (range 6-75). Clinical outcome was evaluated with the "Constant-Murley shoulder score." All the informations about the presence of complications were gathered, and radiological images were used to calculate the head-shaft angle. The overall mean Constant score was 61.93 ± 18.59, the Individual CS was 70 ± 20 % and the Relative CS was 83 ± 23 %. No significant differences were found between fractures Neer 3 and Neer 4 and between the surgical approaches (delta-split vs. delto-pectoral). Six patients had a fracture with dislocation, seven patients (12.7 %) had complications while in four patients a head-shaft angle beyond the normal range was found. Osteosynthesis with PHILOS plate is stable in the greater part of the cases, and it allows an earlier rehabilitation and so a good functional result, which could be compromised by a prolonged immobilization. Therefore, PHILOS plate is a good option for the treatment of complex proximal humerus fractures.
authors.affiliation: Orthopedic Clinic, Padova University Hospital, Via Giustiniani 2, 35100, Padua, Italy. davide.fattoretto@gmail.com.
authors.forename: D
authors.initials: D
authors.lastname: Fattoretto
authors.affiliation: Orthopedic Unit, Padova University Hospital, Via Giustiniani 2, 35100, Padua, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Borgo
authors.affiliation: Orthopedic Clinic, Padova University Hospital, Via Giustiniani 2, 35100, Padua, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Iacobellis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D004867:Equipment Design; D005260:Female; D000072039:Fracture Dislocation / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000295:instrumentation* / Q000379:methods / Q000534:rehabilitation; D017102:Fracture Healing; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010020:Osteonecrosis / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications; D020127:Recovery of Function; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012784:Shoulder Fractures / Q000000981:diagnostic imaging / Q000534:rehabilitation / Q000601:surgery*; D016896:Treatment Outcome
keywords: Osteosynthesis; PHILOS; Plate; Proximal humeral fractures
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