Functional Outcome of Proximal Humerus Internal Locking System (PHILOS) Plating in Proximal Humerus Fractures

Prognosis of proximal humerus fractures depends on the number of fracture fragments; a four-part fracture has a poorer prognosis than two or three-part fractures. The proximal humerus internal locking system (PHILOS) (DePuy Synthes, Johnson & Johnson, MA, USA) plate was designed to provide angular stability, especially in osteoporotic bones, and to decrease the high complication rates associated with these fractures. The present study is an attempt to further establish the findings and outcome of PHILOS plating in proximal humerus fractures.

Around 59 patients with proximal humerus fractures were enrolled in our study, and PHILOS plating was done. Demographic details of the patient, mode of injury, type of fracture, associated injuries, and time since injury were recorded. Patients were followed at an interval of two weeks, six weeks, three months, and six months. Radiographic evaluation was done at each follow-up to assess fracture union and any complications. Functional outcome was assessed using the 100-point Constant-Murley scoring system.

According to Neer's classification, there were 22 (37.3%) patients each classified as type 2 and 3, while the remaining 15 (25.4%) were classified as type 4. The mean Constant-Murley score was 53.88±12.31 at first follow-up as compared to 71.25±14.69 at final follow-up, thereby showing an increase of 17.37±4.62. At final follow-up, functional outcome was rated as very good, good, fair, and poor in 12 (20.3%), 22 (37.3%), 16 (27.1%), and 9 (15.3%) cases, respectively.

The present study showed low post-operative complication rates and sustainable improvement in the functional status of patients in subsequent follow-ups after PHILOS plating.