Locking compression plate for proximal humerus fracture: A functional outcome analysis

Abstract

Introduction: Proximal humerus fractures are often the result of a fall in an osteoporotic patient, but can also occur in young adults due to high energy trauma. They account for 4-5% of all fractures. Over the past few decades, several operative techniques have been described for the treatment of proximal humerus fractures. Currently locking compression plate is gaining popularity. This plate combines the feature of compression of regular plate and locking into one system. Methods: The present study is a prospective study conducted at Department of Orthopedics, S.B.H. GMC Dhule over a period of 2 years from March 2015 to March 2017. Total 34 patients of proximal humerus fracture which were admitted in Orthopedics ward were included in the present study. X ray of proximal humerus was taken and the fractures were classified according to Neer’s classification. All the patients were subjected for open reduction and internal fixation withlocking compression plate i.e. PHILOS (Proximal Humerus Interlocking System). Fracture approached through anterior deltopectoral approach. Post operatively patients were mobilized as early as possible. Patients were followed up and functional outcome was assessed using Neer’s functional scoring system. Mean follow up was 1 year. Results: All the 34 patients of displaced proximal humerus were operated by open reduction and internal fixation using locking compression plate (PHILOS). Among these 19 (55.88%) were males and 15 (44.12%) were females. Age of patients ranged from 29 to 75 years with mean of 52 years. All fractures were classified according to Neer’s functional scoring system. 8 (23.5%) patientswere typeII, 11(32.35%) were type III and 15 (44.11%) were type IV. Functional outcome was assessed using Neer’s functional scoring system. According to Neer’s score 60% of our patients had satisfactory to excellent results and 40% of the patients had unsatisfactory to poor results. Conclusion: According to present study results of locking compression plate, PHILOS, for proximal humerus fracture type II and type III are satisfactory and encouraging in all age groups. Still there is scope to improve results in type IV fractures especially in elderly with osteoporotic bones.