Application of long proximal humeral internal locking system fixation for treatment of complex middle-proximal humeral shaft fractures

Abstract

Objective To investigate the method and clinical efficacy of long proximal humeral internal locking system (PHILOS) fixation in the treatment of complex middle-proximal humeral shaft fractures. Methods From January 2012 to April 2017, 9 cases of complex middle-proximal humeral shaft fractures were treated with long PHILOS fixation. According to AO/OTA classification, 1 case was type B2, 2 cases were type B3 and 6 cases were type C3. Constant-Murley shoulder scoring system was used to evaluate the function and calculate the percentage of the score, percentage of affected side score to healthy side score. Results Postoperatively all the 9 patients were follow-up for 12 to 48 months with an average of 20 months. All the fractures healed without wound infection and vascular and nerve injuries. According to Constant-Murley shoulder score, the average score of the affected side at the last follow-up was 82.3, ranging from 64 to 95. The percentage of scores ranged from 71% to 97%, with an average of 85.1%. The results were rated as excellent or good in 7 cases and fair in 2 cases. Conclusion Long PHILOS fixation is an effective method for treatment of complex middle-proximal humeral shaft fractures. The effective treatment of combined injuries, correct choice of operative timing, good techniques of fracture reduction and fixation are the keys to successful treatment. Key words: Humeral fractures; Treatment outcome; Fracture fixation,internal; Locking plate