Study of functional outcome following proximal humeral internal locking system plating for displaced proximal humeral fractures

Proximal humerus fractures accounts for about 4 to 5% of all fractures. They are the third most common fractures in elderly population after hip and distal radius fractures. Regarding treatment of proximal humerus fractures, controversies still exists whether to do conservative or operative management. Various operative procedures are carried out, recent trend in internal fixation has moved on to locking plates. The present study is undertaken to evaluate the functional outcome and complication of proximal humerus fractures treated by philos locking plate. This is a prospective study involving adults (>18yrs) with proximal humerus fractures admitted to AJ Institute of medical sciences and research centre, Mangalore. In this study period 30 cases of fractures of proximal humerus were treated by open reduction and internal fixation with Philos locking plate were evaluated. In our series, majority of the patients were males with road traffic accident being the commonest mode of injury involving 2 part, 3 part and 4 part fractures of proximal humerus and fracture dislocations. The fractures united in all 30 patients. Among the 30 patients 2(6.7%) patients had an excellent outcome, 10(33.3%) patients had a good outcome, 13(43.3%) patients had a fair outcome, and 5(16.7%) patients had a poor outcome according to constant and murley scoring system. In conclusion Philos locking plate is an advantageous implant in proximal humeral fractures due to angular stability, particularly in comminuted fractures and in osteoporotic bones in elderly patients, thus allowing early mobilization.