Abstract:

Objective: Traumatic proximal humeral fractures can be managed either with conservative or surgical treatment. We aim to assess the clinical and functional outcome and complications of proximal humerus fractures treated surgically with Philos plate. Materials and Methods: Between 2009 and 2013, 36 patients (19 male, 17 female) with proximal humerus fracture who underwent open reduction and internal fixation with Philos plate were included in this study. Mean age was 50 years (range: 29-73 years) and mean follow-up time was 17 months (range: 12-23 months). Fractures were classified according to Neer classification system. 22 patients had comminuted fractures, 6 had fracture-dislocations, 7 had two-part fractures, 1 had fracture extending to proximal metaphysis. A deltopectoral incision was used for all patients. Passive shoulder exercises were commenced on postoperative 2nd day and active exercises were commenced on postoperative 4th - 6th weeks. Functional outcome was assessed according to Constant–Murley score. Results: In 32 of 36 patients the fracture had progressed to clinical and radiological union within 10 weeks. The mean Constant–Murley score was 82 points (range: 62-95). Postoperative infection occured in 2 patients that resolved with hiperbaric oxygen therapy and antibiotic coverage. One patient underwent revision because of loosening of the implant. Subacromial impingement was observed in two patients becasue of high plate fixation. Avascular necrosis was observed in one patient. None of the patients had intraoperative complications or neurovascular complications. Conclusion: The Philos plate fixation of proximal humeral fractures allows early motion and have high union and low complication rates. Thus, Philos plate fixation is appropriate treatment option for proximal humerus fractures.

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