Aliuddin Akram Muhammad, Idrees Zaki, Rahim Najjad Muhammad Kazim, Ali Shah Syed Amir
Department of Orthopaedics, Liaquat National Hospital, Karachi,Pakistan.
J Ayub Med Coll Abbottabad. 2016 Apr-Jun;28(2):337-340.
Proximal humeral fractures account for 4-5% of all fractures. Most fractures are minimally displaced and can be managed non-operatively in adults. Displaced and unstable fractures are difficult to manage and should be treated to achieve painless shoulder and full function. Our aim was to evaluate the functional outcome of proximal humerus fractures (Neers classification 2 part, 3 part and 4 part) treated with PHILOS (Proximal humeral internal locking system).
We retrospectively reviewed 22 patients who had proximal humerus fractures treated with PHILOS plate from Jan 2012 to June 2013 conducted at Orthopaedic Department Liaquat National Hospital. Clinical outcome was measured using DASH (disability of arm, shoulder and hand) Score System. Radiological union was assessed by serial X rays.
Two patients were lost to follow up. Mean age was 40 years (20-70). Mean follow up was 6 months. 4 patients had two-part fracture, 10 patients had three-part and 6 patients had four-part fracture. Radiological union was achieved in average 8.31 weeks (±1.37SD). Average DASH score in young patients was 15.14 (±1.91SD) and in elderly was 31.66 (±4.08SD). One case of implant failure was noted. Better results in younger patients were achieved as compared to elderly proved by DASH score.
Increase in number of fracture parts and delay in treatment did not affect the outcome. Our study concluded that this implant provides stable fixation in younger patients with good quality bone sufficient to allow mobilization.
肱骨近端骨折占所有骨折的4% - 5%。大多数骨折移位极小，成人可采用非手术治疗。移位且不稳定的骨折治疗困难，应进行治疗以实现无痛肩部和完全功能。我们的目的是评估采用PHILOS（肱骨近端内锁定系统）治疗的肱骨近端骨折（Neer分类2部分、3部分和4部分）的功能结果。
我们回顾性分析了2012年1月至2013年6月在利亚卡特国家医院骨科用PHILOS钢板治疗肱骨近端骨折的22例患者。使用DASH（手臂、肩部和手部功能障碍）评分系统测量临床结果。通过系列X线评估放射学愈合情况。
2例患者失访。平均年龄为40岁（20 - 70岁）。平均随访6个月。4例为两部分骨折，10例为三部分骨折，6例为四部分骨折。放射学愈合平均在8.31周（±1.37标准差）实现。年轻患者的平均DASH评分为15.14（±1.91标准差），老年患者为31.66（±4.08标准差）。记录到1例植入物失败。DASH评分证明，与老年患者相比，年轻患者取得了更好的结果。
骨折部分数量的增加和治疗延迟并未影响结果。我们的研究得出结论，这种植入物为骨质良好的年轻患者提供稳定固定，足以允许活动。
