Philos Plate Fixation for Displaced Proximal Humeral Fractures

Fazal, Muhammad; Haddad, FS

doi:10.1177/230949900901700104

Cited by 57 publications

(52 citation statements)

References 30 publications

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“…In our study, total of 7 patients out of 32 had complications (21.8%). In literature, the reported complication rates are ranging from 3.7% to 35.7% [9,11,12] The main complication in our study was inadequate reduction of the fracture ( Fig. 1).…”

Section: Discussionmentioning

confidence: 81%

Is PHILOS as good as it sounds to be? Analysis of complications and functional outcome of PHILOS plating

Na¹,

Sk²

2017

Int. J. Orthop. Sci.

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Aim: Proximal humeral fractures have posed a challenge for internal fixation. Among several methods, most recently, PHILOS (Proximal humeral Internal Locking system) plates have been promoted as most effective method to achieve fixation and union. However, there are no enough studies evaluating the complications and outcome of PHILOS plating. Some studies have shown complication rates ranging from 3.7% to 33.5%. So with this study, we aim to analyze the efficacy and the functional outcome following open reduction and internal fixation with PHILOS plate for displaced proximal humerus fractures. Methodology: In this study, we identified 38 patients in our orthopaedic unit treated surgically by open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate from January 2013 to December 2016. All those patients who had a radiographic and regular clinical follow-up for at least 6 months were included in the analysis. Surgery was done for displaced 2-part, 3-part and 4-part proximal humerus fractures (Neer's Classification) through deltopectoral approach during the time period. Six patients who did not fit into inclusion criteria, did not attend regular follow-up or had incomplete records were excluded from analysis. The study group comprising 32 patients was analyzed for complications and functional outcome by studying patient records and x-rays. The functional outcome was measured using Constant shoulder scoring system. Results: 68% of the patients were males (22 males and 10 females) and male to female ratio was 2.2:1. The mean age of the patients was 47 ± 16 years (Range 31-63 years). Involvement of left side proximal humerus fracture was more common (58%). 55% patients had 2-part fracture according to Neer's classification. The range of movements at first, second and third follow ups increased gradually during subsequent follow ups. According to Constant Shoulder scores, 50% of the patients had excellent outcome followed by 21.9% good, 12.5% fair and 15.6% poor outcome. Total of 7 patients out of 32 had complications (21.8%) and most common complications noted were inadequate reduction, subacroimial impingement, adhesive capsulitis and loss of varus reduction. There were no nerve injuries or infection. Conclusion: Proximal humeral internal locking system (PHILOS) plate for the treatment of proximal humerus fractures leads to a satisfactory functional outcome in majority of the patients. However, functional results depend on correct anatomical reduction of the fracture and stable fixation. Complications still occur due to fracture severity and lack of technical expertise. However, complications like inadequate reduction, varus malalignment, subacromial impingement can still occur with this system. Varus malalignment was found to be a strong predictor of poor functional outcome.

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Section: Discussionmentioning

confidence: 81%

Is PHILOS as good as it sounds to be? Analysis of complications and functional outcome of PHILOS plating

Na¹,

Sk²

2017

Int. J. Orthop. Sci.

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“…Keeping in mind the various possible advantage of proximal humerus locking plate. [1,4,8,14,16,29,32,33,37,38,42] In the present study, the average age was lower because a sizeable number of the patients (8 patients) sustained a high energy trauma in road traffic accident. It is pertinent to mention that younger age group is more likely to be outgoing and exposed to road traffic accident as compared to older age group.…”

Section: Section: Orthopaedicsmentioning

confidence: 82%

“…To achieve this goal, a variety of implants of internal fixation have been employed with variable success.Implants can range from percutaneous k-wiring conventional plates such as T plate , [9,36,39,44] blade plate one third tubular plate43,circlage or tension band wiring using a stainless steel wire, [26,38,24] helix wiring, [35] externalfixator, [28,30] intramedullary nail, [14,20,23,24,25,27,41] locking plate, [1,4,8,14,16,29,32,33,37,38,42] to hemiarthoplasty. [19] The best treatment for displaced proximal humerus fracture remains controversial and the discussion about ideal implant for such cases still continues.…”

Section: Section: Orthopaedicsmentioning

confidence: 99%

Philos Plating in Displaced Surgical Neck of Humerus Fracture

Sharma¹,

Dhingra²,

Sharma³

2017

Ann. Int. Med. Den.Res.

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Variations in the arterial pattern of the upper limb are very common as observed in many cadaveric and angiographic studies. Knowledge of variations in the origin and course of the radial artery is important because they are used for many diagnostic procedures as well as vascular and reconstructive surgeries like coronary angiography, percutaneous coronary intervention and coronary artery bypass surgery. During routine dissection in our institute, we observed a case of high origin of the radial artery in a 33 year old male cadaver. It was found to be unilateral; on left side, radial artery was taking origin from 3 rd part of the axillary artery at the lower border of pectoralis minor before the origin of subscapular artery and anterior circumflex humeral artery. It had a superficial course in the arm crossing the median nerve from medial to lateral side. The further course of this superficial radial artery in the forearm was normal and it terminated by forming a deep Palmar arch in hand. These variations may be of great clinical implications for vascular and plastic surgeons and radiologists. Superficial course of radial artery makes it vulnerable to accidental injuries and elevates the risk of bleeding.

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“…Ramachander Siwach et al [8] treated 12 two part and 13 three part fracture using LCP. MA Fazal et al [6] treated 27 of their cases (13 two part and 12 three part) using PHILOS plating. When compared with other studies present study shows less complications.…”

Section: Methodsmentioning

confidence: 99%

Proximal humerus fracture treated with proximal humerus locking plates. (Philos): A functional outcome

Srinivas¹,

Gadicherla²,

Anudeep³

et al. 2018

Int. J. Orthop. Sci.

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It has always been an engima for the management of such fractures because of numerous muscles attachment and paucity of space for fixing implant in fracture of proximal humerus. The object of the osteosynthesis is to reduce the displacement (usually rotation) of each fragment and hold it in place with an implant and allowing early mobilization. Objective: To evaluate the functional outcome of proximal humerus fractures treated with proximal humerus locking plates (PHILOS). Material and Methods: Using Neer's classification twelve patients of proximal humerus fractures were treated by open reduction and internal fixation with PHILOS plate through deltopectoral approach and were evaluated by Neers criteria at the end of follow up. Results: All the fractures of proximal humerus who met the inclusion criteria were treated with (PHILOS) plate. Proximal humerus fracture is common in age group of 31 to 40 years (41%). 8 out 12(58%) patients were male. In the present study 8(67%) cases had 2 part fracture; 3(25%) cases had 3 part fracture and one case (8%) had 4 part fracture. In our study we had 4 Excellent (34%) and 7 satisfactory (58%) results and 1 had unsatisfactory (8%) according to Neer's criteria. Out of 12 patients, 2(17%) had complication.1 patient (8.5%) had superficial infection and 1 patient (8.5%) had stiffness of the shoulder Conclusion: From our study it can be safely recommended that for proximal humerus fractures, PHILOS plating is a good choice of surgical treatment.

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Philos Plate Fixation for Displaced Proximal Humeral Fractures

Abstract: Philos plate fixation provided stable fixation, minimal metal work problems and enabled early range-of-motion exercises to achieve acceptable functional results.

Cited by 57 publications

References 30 publications

Is PHILOS as good as it sounds to be? Analysis of complications and functional outcome of PHILOS plating

Is PHILOS as good as it sounds to be? Analysis of complications and functional outcome of PHILOS plating

Philos Plating in Displaced Surgical Neck of Humerus Fracture

Proximal humerus fracture treated with proximal humerus locking plates. (Philos): A functional outcome

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