IJSR - International Journal of Scientific Research

DR.NIHAL.R.RAI; SHARATH BELLEMANE

Volume : VI, Issue : III, March - 2017

A prospective study to assess the surgical outcome in three and four part proximal humerus fracture with PHILOS plate

Dr. Nihal. R. Rai, Sharath Bellemane

Abstract :

Background: Optimal surgical management of three and four–part proximal humeral fractures in osteoporotic patients is controversial, with many advocating prosthetic replacement of the humeral head. Proximal humerus interlocking osteosynthesis that maintain angular stability under load have been proposed as an alternative to hemiarthroplasty for the treatment of three and four–part proximal humeral fractures. Methods: The records of 50 patients with mean age of 57.5 years. Neer three part proximal humeral fracture were 18 , four–part proximal humeral fracture were 32. All patients were treated surgically between Jan 2008 to dec 2010.All patients had radiographic and clinical follow–up performed at 1 ,3, 6 month and 1 yr, Clinical outcomes were measured with use of the Constant–Murley system. This study was based on level 1 of evidence Results: The mean Constant score (and standard deviation) at the time of final follow–up was locked–plate. The mean Constant score was 80 (range, 40–100). Complications with this fixation included osteonecrosis in 1 patient, malunion in 1 patient, Axillarynervepalsy in 1 patient, Impingement syndrome in 1 patient. Conclusions: The most important factor for favorable outcome in 3 and 4 part fractures in proximal end humerus gives accurate anatomical reduction which is achieved by locking plate osteosynthesis with multiplanar screws . It is a safe and effective method with minimal tissue damage, higher primary stability and load transfer through the implant are important to avoid complications. The PHILOS Plate produces promising functional outcomes.