Functional outcome of proximal humeral interlocking system plating for displaced proximal humeral fractures: A prospective study

Dr. Pavankumar Patted, Dr. Md. Sadiq
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Abstract

Background: The study was conducted to assess functional outcome of Proximal Humerus InterLocking System (PHILOS) plating in displaced proximal humeral fractures by Constant-Murley (Subjective and Objective) score. Materials and Methods: The study was conducted for 30 patients with displaced proximal humeral fractures operated with Proximal Humerus InterLocking System. Among 30 patients 12 females, 18 males; mean age 50.64 years range (26-70yrs). All patients were put on same physiotherapy program following internal fixation with the PHILOS plate. The patients were assessed clinically and radiographically at regular intervals of 6 weeks, 12 weeks and 6 months. Functional outcome was assessed using the Constant-Murley score. Complications during the follow-up period were recorded. Results: In our series of 30 patients 2-part fractures were more common accounting 60 % compared to 3part (20%) and 4-part (20%). Fractures united in all patients. The most frequent complication seen was shoulder stiffness in 6 patients. Excellent functional outcome seen in 9 (30%) cases, good 12 (40%) cases, fair 6(20%) cases, poor 3(10%) cases. Conclusion: Fixation of proximal humerus fractures with proximal humerus locking plates is associated with satisfactory functional outcomes in 2-part and 3-part and 4 part fracture. The complications are high in four part fractures and old age. Good surgical skills and surgeon’s experience are of utmost importance for successful operative treatment.
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肱骨近端联锁系统钢板治疗移位的肱骨近端骨折的功能效果:一项前瞻性研究
背景:本研究采用Constant-Murley(主观和客观)评分法评估肱骨近端互锁系统(PHILOS)钢板在移位肱骨近端骨折中的功能效果。材料与方法:本研究对30例肱骨近端移位骨折患者进行肱骨近端联锁系统手术。30例患者中女性12例,男性18例;平均年龄50.64岁(26-70岁)。所有患者在PHILOS钢板内固定后接受相同的物理治疗方案。每隔6周、12周和6个月对患者进行临床和影像学评估。功能结局采用Constant-Murley评分进行评估。记录随访期间的并发症。结果:在我们的30例患者中,2部分骨折更常见,占60%,而3部分(20%)和4部分(20%)骨折更常见。所有患者骨折愈合。6例患者最常见的并发症是肩关节僵硬。功能预后优9例(30%),良12例(40%),一般6例(20%),差3例(10%)。结论:肱骨近端锁定钢板固定肱骨近端骨折可获得满意的2、3、4部分骨折功能结果。四部分骨折和老年人并发症多。良好的手术技巧和外科医生的经验对手术治疗的成功至关重要。
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