A Study on Outcome of Surgical Neck Humerus Fractures Managed Operatively by Proximal Humerus Interlocking (PHILOS) Plate

Introduction : Proximal humerus fractures account for about 5 % of all injuries to appendicular skeleton and among proximal humerus fractures, surgical neck humerus fractures are most common type and account for 25 % of the fractures of proximal region. The treatment of these fractures ranges from the conservative management in minimally displaced fractures to primary shoulder replacement arthroplasty in more comminuted fractures. The aim of this study was to assess the outcome of surgical neck humerus fractures managed by PHILOS plating. Materials and Methods: A total of 25 patients with surgical neck humerus fractures were in included in this study after careful inclusion and exclusion criteria and were classified according to Neer’s classification and were operated with PHILOS plate and were then followed at regular intervals. The final outcome was assessed based on Constant-Murley score and DASH score. Results: According to Constant-Murley score excellent results were achieved in 12 (48 %) patients, good results in 7 (28 %) patients, fair results in 5 (20 %) patients and poor results in 1 (4 %) patient. According to DASH score 23 (92 %) patients had excellent results and 2 (8 %) patients had Good results. Infection was observed in 2 (8 %) patients and avascular necrosis of humeral head (AVN) was observed in 1 (4 %) patient non-union with implant failure was observed in 1 (4 %) patient and screw cut out was observed in 3 (12 %) patients. Conclusion: PHILOS plate is a very promising implant for surgical neck humerus fracture due to its provision of giving inferomedial support by locking screws (calcar screws) which prevent the varus displacement of the proximal fragment along with the buttressing effect laterally and provides excellent to good functional outcome.