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Journal of Bone and Joint Surgery - British Volume, Vol 89-B, Issue 9, 1206-1209.
doi: 10.1302/0301-620X.89B9.18528  
Copyright © 2007 by British Editorial Society of Bone and Joint Surgery
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Early results for treatment of three- and four-part fractures of the proximal humerus using the PHILOS plate system

P. Moonot, MRCS MS(Orth), DNB(Orth), Clinical Research Fellow1; N. Ashwood, FRCS(Orth), Consultant Orthopaedic Surgeon2; and M. Hamlet, FRCS(Orth), Consultant Orthopaedic Surgeon2

1 South West London Elective Orthopaedic Centre, Dorking Road, Epsom, Surrey, UK.
2 Queens Hospital, Belvedere Road, Burton-on-Trent, UK.

Correspondence should be sent to Mr P. Moonot; e-mail: drmoonot{at}yahoo.co.uk

Secure fixation of displaced proximal fractures of the humerus is a challenging problem. A total of 32 patients with acutely displaced three- or four-part proximal fractures of the humerus were treated by open reduction and internal fixation using the proximal humeral internal locking system (PHILOS) plate. There were 23 women and nine men with a mean age of 59.9 years (18 to 87). Data were collected prospectively and the outcomes were assessed using the Constant score. The mean follow-up was for 11 months (3 to 24). In 31 patients (97%) the fracture united clinically and radiologically at a mean of 10 weeks (8 to 24). The mean Constant score at final review was 66.5 (30 to 92). There was no significant difference in outcome when comparing patients aged more than 60 years (18 patients) with those aged less than 60 years (14 patients) (t-test, p = 0.8443). There was one case each of nonunion, malunion and a broken screw in the elderly population.

This plate provides an alternative method of fixation for fractures of the proximal humerus. It provides a stable fixation in young patients with good-quality bone sufficient to permit early mobilisation. Failure of the screws to maintain fixation in the elderly remains a problem.




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Hip, Knee, Trauma, Upper limb, Foot & Ankle, Paediatrics, Oncology, Spine, Arthroplasty, General