Sathavu Panthala Priyan, Kothimbakkam Prem Kumar, Murugan P Bala, Mohideen Sheik, Murugesan Vijayashankar, Ranganathan Thirumal
Department of Orthopaedics, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, Tamil Nadu, India.
Department of Orthopaedics and Traumatology, Tagore Medical College and Hospital, Chennai, Tamil Nadu, India.
J Orthop Case Rep. 2025 Jun;15(6):294-299. doi: 10.13107/jocr.2025.v15.i06.5742.
Fractures of the proximal humerus are the second most common upper extremity fracture and the third most common fracture, after hip and distal radial fractures. The fractures can occur at any age, but the incidence rapidly increases with age. Common complications following non-operative management of proximal humeral are pain, stiffness, and loss of function. The following study was conducted to evaluate the functional and radiological outcome of displaced proximal humeral fractures treated with the proximal humerus internal locking osteosynthesis system (PHILOS).
The study was conducted in patients treated for displaced proximal humerus fracture (Neer's 2-part, 3-part, 4-part, and associated with dislocation) between the period of April 2022-April 2024. Twenty proximal humerus fracture patients were taken into the study; all were fixed with PHILOS plate. Patients' ages ranged from 18 to 75 years, with a mean of 53.6 years.
In our study, the sample size of twenty patients of proximal humeral fractures. 10 were males and 10 were females. The patients' ages ranged from 18 to 75 years, with a mean age of 53.6 years. The causes of fractures were self-fall in 12 patients and road traffic accident in 8 patients. Fourteen fractures involved the right side and 6 involved the left. Patients were followed up from 4 weeks, 12 weeks, and 6 months. Functional outcome was rated as per Constant-Murley Shoulder score, we got excellent results in 07 patients, good in 10 patients, moderate in 02 patients, and poor in 01 patient. The mean Constant-Murley score of this study at the end of the final follow-up period was 81.26.
The majority of proximal humerus fractures in elderly people results from fall on outstretched hand in an osteoporotic bone. As PHILOS plate has options for more number of screws for humeral head than conventional locking plate, it will lead to more stable fixation of fracture fragments and early mobilization of the patients. The functional outcome of Neer's 2- and 3-part fractures is better than Neer's 4-part fractures. The radiological outcome, assessed through quality of reduction and bony union, is better in Neer's 2- and 3-part fractures as compared to Neer's 4-part fractures. We concluded that proximal humeral fractures, when treated surgically, especially using the PHILOS plate, provided stability, early mobilization, and good range of motion.
肱骨近端骨折是上肢第二常见的骨折，也是继髋部骨折和桡骨远端骨折之后第三常见的骨折。此类骨折可发生于任何年龄，但发病率会随年龄迅速上升。肱骨近端骨折非手术治疗后的常见并发症包括疼痛、僵硬和功能丧失。本研究旨在评估采用肱骨近端锁定接骨板系统（PHILOS）治疗移位型肱骨近端骨折的功能和影像学结果。
本研究纳入了2022年4月至2024年4月期间接受治疗的移位型肱骨近端骨折患者（Neer 2部分、3部分、4部分骨折以及合并脱位的骨折）。20例肱骨近端骨折患者纳入研究，均采用PHILOS接骨板固定。患者年龄在18至75岁之间，平均年龄为53.6岁。
在我们的研究中，肱骨近端骨折患者样本量为20例。男性10例，女性10例。患者年龄在18至75岁之间，平均年龄为53.6岁。骨折原因包括12例自行摔倒和8例道路交通事故。右侧骨折14例，左侧骨折6例。对患者进行了4周、12周和6个月的随访。根据Constant-Murley肩关节评分评估功能结果，7例患者结果为优，10例为良，2例为中，1例为差。本研究在最终随访期结束时的平均Constant-Murley评分为81.26。
老年人多数肱骨近端骨折是因骨质疏松的骨头在伸展手部时摔倒所致。由于PHILOS接骨板比传统锁定接骨板在肱骨头处有更多的螺钉选择，这将使骨折碎片固定更稳定，患者能更早活动。Neer 2部分和3部分骨折的功能结果优于Neer 4部分骨折。与Neer 4部分骨折相比，通过复位质量和骨愈合评估的Neer 2部分和3部分骨折的影像学结果更好。我们得出结论，肱骨近端骨折手术治疗时，尤其是使用PHILOS接骨板，能提供稳定性、早期活动能力和良好的活动范围。
