Clinical and Functional Outcomes of Proximal Humerus Internal Locking System Plate Fixation in Proximal Humerus Fractures: A Short-term Follow-up.

Abstract

Introduction: Proximal humerus fractures (PHFs) are among the most frequently encountered fractures in clinical orthopedic practice, particularly in the elderly population. Although many cases can be managed conservatively, complex and displaced fractures often require surgical intervention. Proximal humerus internal locking system (PHILOS) plating has emerged as an effective treatment modality in these cases, especially in osteoporotic bone.

Materials and methods: This retrospective cum prospective clinical study was conducted over 2 years and included 30 patients aged 18-65 years with PHFs treated surgically with PHILOS plating. Fractures were classified using Neer's classification. Patients were followed for a minimum of 4 months. Functional outcomes were assessed using the Constant-Murley score.

Results: The mean age of patients was 39.56 ± 9.41 years, with a majority being in the age group of 30-50 years. The distribution of fractures included 2-part (33.3%), 3-part (56.6%), and 4-part fractures (10%). At the final follow-up, 46.7% of patients had excellent outcomes, 30% good, 13.3% fair, and 10% poor. The mean Constant-Murley score was 78. Patients with 2-part fractures had the highest mean score (81.2), followed by 3-part (78.8), and 4-part fractures (59.3).

Conclusion: PHILOS plate fixation for PHFs provides stable internal fixation, enables early mobilization, and leads to good-to-excellent functional outcomes, particularly in less complex fracture patterns. Early rehabilitation further enhances recovery.