Comparison of the functional outcome of Philos Plate Vs. external fixator in the management of proximal humerus fracture

Abstract

Background: Proximal humerus fractures, are a major medical issue that are relatively prevalent. 4-5% of all fractures are proximal humeral fractures, most of which involve older and osteoporotic individuals. Objectives: To compare the functional outcome of philos plate vs. external fixator in the management of proximal humerus fracture. Material and Methods: A retrospective comparative study was conducted at the Department of Orthopaedic Surgery, Ghurki Trust Teaching Hospital, Lahore. From November 23, 2022, to May 23, 2023. After approval from the hospital's ethical board, 112(56 per group) patients were included in the study through an emergency. Informed consent was taken from parents. We stratified patients into two groups. Group A received the treatment of Philos, while Group B received the external fixator treatment. Functional outcome was assessed at the end of 3 months postoperatively using constant shoulder score. The collected data were entered and analyzed accordingly using SPSS version 27. Results: In the current study, a total of 112 patients included underwent two surgical interventions, among these, 56 patients underwent Philos plating while an equal number of patients underwent external fixation. In Group A and B, the majority were males (37:47) out of 112. The mean age of patients was equal in both groups (Group A=44.36±11.71), and the mean age of patients was (Group A=44.88±10.05), ranging from 20 to 80 years. In Group A, the average BMI was less than 24.29±4.23, ranging from 18-35 kg/m2, compared to Group B, 28.89±3.77, ranging from 22-35 kg/m2. 38(67.9%) were effected from right side as in Group A while 41(73.2%) were effected from right side in Group B. Majoruty 28(50.0%) had history of RTA in Group A while patients 24(42.9%) were observed with history of RTA in Group B25(44.6%) cases reported excellent outcome, 6(10.7%) reported very good outcome, 16(21.4%) good, 7(12.5%) fair and 2(3.6%) poor outcome in Group A. In Group B, 36(64.3%) excellent, 7(12.5%) very good, 12(21.4%) cases reported Good and 1(1%) reported fair outcome. So it is concluded that 25(44.6%) cases reported excellent outcome in Group A, comparatively low as compared to Group B 36(64.3%). Only age was significantly associated with excellent outcomes as p<.05. Conclusion: It is concluded that External fixation demonstrated a better outcome as compared to Philos Plating, so in Orthopaedic practice, External fixation should be preferred for patients diagnosed with proximal humerus fracture to get better results and reduce the complications.