Background: Proximal humeral fractures have poor prognosis and many
complications. Usually these are comminuted due to high velocity injuries in young
age or osteoporotic nature of bone in old age which makes surgical intervention
challenging. The results of open reduction and internal fixation becomes more
superior to conservative treatment after evolution of locked plates and anatomically
precontoured plates especially in active patients.
Patient and method: Between January 2016 and April 2017 twenty patient with
comminuted proximal humeral fracture were treated by open reduction and internal
fixation using deltopectoral approach and fixing by PHILOS plate the mean age was
48.6 years (ranged between 20-70 ). All fractures were closed.
Results: Average follow up was 9 months (range 7-10). According to constant
shoulder score the mean score was 76.50 with maximum score 92 and minimum 57.
There were no cases of non union, vascular nor neurological injury.
Conclusion: The use of PHILOS plate in three and four part fracture proximal
humeral fracture is a safe and promising method of fixation with better results than
conservative measures with low complication rate and early rehabilitation and better
patient satisfaction. |