Abstract
Purpose of the study: Our retrospective multicentric study evaluated 2-year results of using a PHILOS plate in treatment of displaced 3- and 4-part fractures of proximal humerus. Material and methods: 120 patients were included in the study (78 women, 42 men, aged 20 to 86).
Patients with multiple injuries and patients with pathological fractures were excluded from the study. 81 patients were older than 65 years and 39 were younger. Deltoidpectoral approach was used in beach-chair position of the patient.
All patients were examined 2 and 6 weeks following the surgery and then at 3, 6 ,9, 12 and 24 months. Functional outcome was evaluated using Constant score.
Standard X-ray imaging was used to evaluate the position of the plate and progress of bone healing. Functional outcome of patients older than 65 years was compared to younger patients.
Results: Average period of follow-up was 24 months (8 to 49). Total of 117 patients were primarily healed both clinically and radiologically speaking.
Average healing time was 11,5 weeks (7 to 20) from the surgery. Average Constant score at final examination was 73,7.
Average Constant score in patients older than 65 years was 71,3 (36 to 80), in younger patients it was 74,5 (42 to 96). We did not prove a statistically significant difference of functional outcome between younger (65 years).
Using a PHILOS plate was not associated with higher number of complications (7,5%). Discussion: Depending on our retrospective study we consider that using a PHILOS plate brings good results in treatment of patients with displaced 3-and 4-part fractures of proximal humerus, secures adequate stability with the possibility of early mobilisation without threatening the bone healing and guarantees a good functional and clinical outcome, with a relatively low risk of complications.