Philosplating: Emerged Techniques in Surgical Management

Abstract

Safe fixation of displaced proximal fracture of the humerus is a challenging problem. A total of 32 patients with acute three- or four-part displace fractures of the proximal humerus were treated with open reduction and internal fixation using the proximal humerus internal locking system (PHILOS). There were 23 women and nine men, with a mean age of 59.9 years (18 to 87). Data were collected prospectively and the results were assessed based on consistent results. The mean follow-up time was 11 months (3 to 24). In 31 patients (97%) the fractures were combined clinically and radiologically for a mean of 10 weeks (8 to 24). Consistent mean score on recent exams was 66.5 (30 to 92). There was no significant difference in outcome when comparing patients over 60 years of age (18 patients) with patients under 60 years of age (14 patients) (t-test, p = 0.8443). There was one case of parental union, abuse, and fracture.PHILOS provides stable fixation in proximal humerus fractures. To prevent potential complications like avascular necrosis, meticulous surgical dissection to preserve vascularity of humeral head is necessary.