Comparative Evaluation of Functional Outcome of Open Reduction and Internal Fixation With Philos and Closed Reduction and Percutaneous Fixation With K-Wires in Proximal Humeral Fractures

Abstract

Background: Fracture of the proximal humerus represents the second most common (29.1%) fracture type in the upper extremity after Colle's fracture (37.2%) of the wrist. Signicant controversy continues regarding the best modality for treating displaced proximal humerus fractures. The objective of our study is to comparatively evaluate the functional outcome of ORIF with Proximal Humerus Internal Locking System (PHILOS) and Close Reduction and Percutaneous Fixation with K-wires in proximal humerus fractures. Method: A prospective study was conducted after getting ethical approval at N.S.C.B. Medical College & Hospital, Jabalpur, (M.P.) upon 50 cases admitted with proximal humerus fractures as per inclusion criteria. 25 cases were treated with PHILOS plate in group A and 25 patients were treated with Closed Reduction and Percutaneous Fixation with K-wires in group B. Post op follow up was done at 6 weeks and 12 weeks and functional outcome evaluated by Neer's scoring criteria. Results: Out of 50 cases, excellent scores was obtained in 22 (88%) cases treated with PHILOS in group A, and 18 (72%) cases treated with k-wire xation in group B, satisfactory score was obtained in 3 (12%) in Group A and 6 (24%) in Group B. Conclusion: We obtained excellent results in both groups with each procedure having its own advantage and disadvantages. We found that PHILOS provides secure xation with better functional outcome in terms of range of motion. Fixation with Percutaneous K-wires is also efcient treatment option with intraoperative advantage in terms of invasiveness, blood loss and time taken for surgery with least tissue dissection than PHILOS plating