Saraf Amit, Bishnoi Sandeep, Parakh Naman K, Kumar S Krishna, Chaudhary Ananya, Reddy K Dhanunjaya
Department of Orthopaedics, Teerthanker Mahaveer Medical College and Research Centre, Moradabad, Uttar Pradesh, India.
Department of Orthopaedics, Sacred Heart Hospital, Palad, Malappuram, Kerala, India.
J Orthop Case Rep. 2025 Sep;15(9):329-333. doi: 10.13107/jocr.2025.v15.i09.6116.
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.
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.
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).
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.
肱骨近端骨折（PHF）是临床骨科实践中最常见的骨折之一，尤其是在老年人群中。尽管许多病例可以保守治疗，但复杂和移位骨折通常需要手术干预。肱骨近端锁定接骨板系统（PHILOS）接骨板已成为这些病例的有效治疗方式，尤其是在骨质疏松性骨中。
这项回顾性兼前瞻性临床研究历时2年，纳入了30例年龄在18 - 65岁之间、采用PHILOS接骨板手术治疗的肱骨近端骨折患者。骨折采用Neer分类法进行分类。患者至少随访4个月。使用Constant - Murley评分评估功能结果。
患者的平均年龄为39.56±9.41岁,大多数患者年龄在30 - 50岁之间。骨折分布包括两部分骨折（33.3%）、三部分骨折（56.6%）和四部分骨折（10%）。在最后一次随访时，46.7%的患者结果为优，30%为良，13.3%为可，10%为差。Constant - Murley平均评分为78分。两部分骨折患者的平均评分最高（81.2），其次是三部分骨折（78.8）和四部分骨折（59.3）。
PHILOS接骨板固定治疗肱骨近端骨折可提供稳定的内固定，能早期活动，并能带来良好至优秀的功能结果，尤其是在骨折类型不太复杂的情况下。早期康复可进一步促进恢复。
