Dinkar Karuna Shankar, Goyal Amrit, Mittal Vivek, Kapoor Rajat, Chahar Hemant S, Singh Vikas K
Orthopaedics, Sarojini Naidu Medical College, Agra, IND.
Orthopaedic Surgery, Sarojini Naidu Medical College, Agra, IND.
Cureus. 2024 Nov 27;16(11):e74617. doi: 10.7759/cureus.74617. eCollection 2024 Nov.
Background Proximal humerus fractures (PHFs) are often injuries that occur in the field of orthopedics and can either be treated conservatively or operatively. The PHILOS (Proximal Humerus Interlocking System) and the proximal humerus nail (PHN) are the commonly used operative techniques. Objectives The objective of this study is to analyse the functional outcome of the PHILOS (Proximal Humerus Internal Locking System) and the PHN (Proximal Humerus Nail) in proximal humerus fractures. Methods This research included a total of 40 patients; out of them, 20 patients were assigned to the PHN group, while the other 20 patients were assigned to the PHILOS group. Functional outcomes were evaluated using established scoring methods, such as the Constant-Murley Shoulder Outcome score and the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. Results Following the inclusion criteria, a total of 40 patients were found to be eligible for the study. The PHN group had a significantly reduced average surgical time of 75.90 minutes (±5.70 SD) compared to the PHILOS group, which had an average surgical time of 112.50 minutes (±12.93 SD). The average constant score at 12 months follow-up was 72.70±3.51 for PHILOS and 78.35±4.72 for PHN group (p-value<0.001). Conclusion Our study indicates that PHN yields favorable functional outcomes in the treatment of PHFs as compared to PHILOS. Nevertheless, more investigation, such as prospective randomized controlled trials (RCTs) and extended follow-up, is necessary to validate these results.
背景 肱骨近端骨折（PHFs）是骨科领域常见的损伤，可采用保守治疗或手术治疗。PHILOS（肱骨近端锁定系统）和肱骨近端髓内钉（PHN）是常用的手术技术。目的 本研究旨在分析PHILOS（肱骨近端内锁定系统）和PHN（肱骨近端髓内钉）治疗肱骨近端骨折的功能结局。方法 本研究共纳入40例患者；其中，20例患者被分配至PHN组，另外20例患者被分配至PHILOS组。使用既定的评分方法评估功能结局，如Constant-Murley肩关节结局评分和上肢、肩部和手部功能障碍（DASH）问卷。结果 根据纳入标准，共40例患者符合研究条件。PHN组的平均手术时间为75.90分钟（±5.70标准差），显著低于PHILOS组，后者的平均手术时间为112.50分钟（±12.93标准差）。在12个月随访时，PHILOS组的平均Constant评分是72.70±3.51，PHN组是78.35±4.72（p值<0.001）。结论 我们的研究表明，与PHILOS相比，PHN在治疗肱骨近端骨折方面产生了良好的功能结局。然而，需要更多的研究，如前瞻性随机对照试验（RCT）和延长随访，以验证这些结果。
