Fazal M A, Haddad F S
Department of Orthopaedics, Chase Farm Hospital, London, United Kingdom.
J Orthop Surg (Hong Kong). 2009 Apr;17(1):15-8. doi: 10.1177/230949900901700104.
To evaluate the treatment outcome of Philos plate fixation for displaced proximal humeral fractures in 27 consecutive patients.
6 men and 21 women aged 22 to 85 (mean, 56) years underwent Philos plate fixation for displaced proximal humeral fractures. 11 patients were aged 60 years or younger and 16 older than 60 years. All fractures were closed with no associated injuries and classified as 2-part (n=13), 3-part (n=12), and 4-part (n=2), according to the Neer classification. Patients were assessed radiologically and functionally using the Constant shoulder score.
Patients were followed up for 6 to 24 (mean, 13) months. All the fractures united except in a 76- year-old woman with a 3-part fracture in whom there was fracture collapse and screw penetration of the humeral head at 6 weeks. She subsequently developed non-union and avascular necrosis. The mean Constant shoulder score was 70 (range, 28-88). 11 patients had a score exceeding 75, 13 were scored between 50 and 75, and 3 were below 50.
Philos plate fixation provided stable fixation, minimal metal work problems and enabled early range-of-motion exercises to achieve acceptable functional results.
评估连续27例肱骨近端移位骨折患者采用Philos钢板固定的治疗效果。
6例男性和21例女性，年龄22至85岁（平均56岁），因肱骨近端移位骨折接受Philos钢板固定。11例患者年龄在60岁及以下，16例年龄超过60岁。所有骨折均为闭合性，无合并伤，根据Neer分类法分为二部分骨折（n = 13）、三部分骨折（n = 12）和四部分骨折（n = 2）。采用Constant肩关节评分对患者进行影像学和功能评估。
患者随访6至24个月（平均13个月）。除1例76岁女性的三部分骨折外，所有骨折均愈合。该患者在6周时出现骨折塌陷和螺钉穿入肱骨头，随后发生骨不连和缺血性坏死。Constant肩关节评分平均为70分（范围28 - 88分）。11例患者评分超过75分，13例评分在50至75分之间，3例低于50分。
Philos钢板固定提供了稳定的固定，金属相关问题最少，并能早期进行活动度锻炼，以获得可接受的功能结果。
