Surgical management of complex humerus head fractures

Area of Science:

• Orthopedic Surgery
• Trauma Management
• Biomedical Engineering

Background:

• Locked plate systems are effective for elderly osteoporotic proximal humerus fractures.
• The efficacy of the PHILOS plate for high-energy fractures in younger populations remains under investigation.

Purpose of the Study:

• To evaluate the adequacy of the PHILOS plate system for stabilizing high-energy proximal humerus fractures and fracture-dislocations in patients under 55 years old.

Main Methods:

• Retrospective study at a level III trauma center.
• Inclusion of 59 patients under 55 with closed, 3-part, 4-part fractures, or fracture-dislocations.
• Management via open reduction and internal fixation with the PHILOS plate system, with a minimum two-year follow-up.

Main Results:

• Favorable outcomes were observed in 69.5% (41/59) of patients based on Constant, Neer, and DASH scores.
• Results were comparable to those reported for older age groups in existing literature.
• A relatively high complication rate was noted, characteristic of managing severe fractures.

Conclusions:

• The PHILOS plating system can be considered adequate for managing high-energy proximal humerus fractures in polytrauma patients under 55.
• While complications exist, the system provides a viable treatment option for this demographic.