Outcome of fracture of proximal humerus in adults treated with open reduction and internal fixation with proximal humerus locking plate
DOI:
https://doi.org/10.36283/ziun-pjmd15-2/010Keywords:
Use of PHLP in Proximal humerus fracturesAbstract
Proximal humerus fractures are most common upper limb fractures in adults.
Locking plates such as proximal humerus internal locking systems PHILOS have gained popularity for providing angular stability and promoting early mobilization. This study aimed to evaluate the functional and radiological outcomes of PHFS treated with open reduction internal fixation using philos plating in a local adult population at 3 months postoperatively.
Radiological union,demographic variables, comorbidities,,operative duration and hospital stay were analyzed.
Logistic regression was applied to identify to identify factors associated with poor functional outcomes.
This prospective observational study included 140 adult patients with closed PHFs treated with ORIF using PHILOS plates. Functional outcomes were assesed using the constant murley score
Functional outcomes were excellent in 33.6%, good in 24.3% and poor in 12.9% of patients.
Most patients were male with a mean age of 48.6 +- (14.7) years.
References
References
1. Singh Lapner P, Sheth U, Nam D, Schemitsch E, Guy P, Richards R. Management of proximal humeral fractures in adults: a systematic review and meta-analysis. J Orthop Trauma. 2023 Feb 1;37(2):e80-8.
2. Samborski SA, Haws BE, Karnyski S, Soles G, Gorczyca JT, Nicandri G, Voloshin I, Ketz JP. Early outcomes of Proximal Humerus fractures in adults treated with locked plate fixation compared with nonoperative treatment: an Age-, Comorbidity-, and fracture morphology-matched analysis. J Orthop Trauma. 2023 Mar 1;37(3):142-8.
3. Samborski SA, Haws BE, Karnyski S, Soles G, Gorczyca JT, Nicandri G, Voloshin I, Ketz JP. Pavone V, Vescio A, Denaro R, Costa D, Caruso VF, Condorelli G, Sessa G, Testa G. Use of different plate implants for surgical treatment of proximal humerus fractures in adults: a systematic review. Acta Bio Medica: Atenei Parmensis. 2021 Sep 2;92(4): e2021198.
4. Samborski SA, Haws BE, Karnyski S, Soles G, Gorczyca JT, Nicandri G, Voloshin I, Ketz JP. Outcomes for type C proximal humerus fractures in the adult population: comparison of nonoperative treatment, locked plate fixation, and reverse shoulder arthroplasty. JSES Int. 2022 Jun 9;6(5):755-62. doi: 10.1016/j.jseint.2022.05.006. PMID: 36081702; PMCID: PMC9446248.
5. Ma H, Sun J, Ma X, Yang Z, Sun H, Cao D, Si L, Zhao P, Qiao Z. Retrospective analysis of open reduction and locking plate fixation in three and four part proximal humeral fractures with efficacy and complications. Sci Rep. 2025 Jul 2;15(1):23081. doi: 10.1038/s41598-025-07119-x.
6. Haws BE, Samborski SA, Karnyski S, Soles G, Gorczyca JT, Nicandri GT, Voloshin I, Ketz JP. Risk factors for loss of reduction following locked plate fixation of proximal humerus fractures in older adults. Injury. 2023 Feb 1;54(2):567-72.
7. Wang M, Wang X, Cai P, Guo S, Fu B. Locking plate fixation versus intramedullary nail fixation for the treatment of multifragmentary proximal humerus fractures (OTA/AO type 11C): a preliminary comparison of clinical efficacy. BMC musculoskeletal Disord. 2023 Jun 5;24(1):461. doi: 10.1186/s12891-023-06567-8.
8. Padegimas EM, Nicholson TA, Chang G, Hebert-Davies J, Namdari S. Outcomes of open reduction and internal fixation of proximal humerus fracture dislocations. J Shoulder Elbow Surg. 2021 Oct;30(10):2331-2335. doi: 10.1016/j.jse.2021.01.025. Epub 2021 Feb 18. PMID: 33610728.
9. Han SH, Park JS, Baek JH, Kim S, Ku KH. Complications associated with open reduction and internal fixation for adult distal humerus fractures: a multicenter retrospective study. J Orthop Surg Res. 2022 Aug 31;17(1):399. doi: 10.1186/s13018-022-03292-1. PMID: 36045372; PMCID: PMC9429783.
10. Falsafi M, Altini S, Baghianimoghadam B, Bahrami-Nejad E, Ganji SMR, Hajiahmadi M, et al. The outcome measure of proximal humerus fracture treated by open reduction and internal fixation with proximal humerus internal locking system based on oxford shoulder score. (Qassim). 2022 Sep-Oct;16(5):49-57. PMID: 36101849; PMCID: PMC9441643.
11. Buchmann L, van Lieshout EMM, Zeelenberg M, den Hartog D, Pfeifer R, Allemann F, et al. Proximal humerus fractures (PHFs): comparison of functional outcome 1 year after minimally invasive plate osteosynthesis (MIPO) versus open reduction internal fixation (ORIF). Eur J Trauma Emergency.
12. M. MN, Shakeeb K. U. M, A. J. G. Functional outcome following open reduction and internal fixation of proximal humerus fractures with locking compression plate. Int J Res Orthop 2021 Jan;7(1):29.
13. Pop H, Morcovesc A, Mihai MM, Constantinescu AS, Bica F, Constantinescu A. Open reduction and internal fixation with proximal humerus locking plate, screws, and fibular strut graft: an alternative to shoulder arthroplasty and solution to medial instability and varus collapse in comminuted proximal humerus fractures. Cureus. 2024 Jan 29;16(1).
14. Dasari SP, Kerzner B, Fortier LM, Rea PM, Bodendorfer BM, Chahla J, et al. Improved outcomes for proximal humerus fracture open reduction internal fixation augmented with a fibular allograft in elderly patients: a systematic review and meta-analysis. J Shoulder Elbow Surg. 2022 Apr;31(4):884-894. doi: 10.1016/j.jse.2021.11.004. Epub 2021 Dec 11. PMID: 34906682.
15. Tran DQ, Nguyen SA, Dang AH. Clinical outcomes of locking plate fixation for proximal humerus fractures in patients aged 60 and older: A retrospective cohort study in Vietnam. J Orthop Rep. 2025 Jul 23:100742.
16. Singh H, Boinapally V, Kumar T. A prospective study on Clinical and functional outcome of proximal humerus fractures treated with locking compression plate (LCP) among adults. Eur J Molecule Clin Med. 2022 Jul 15;9(7):5650-64.
17. Falsafi M, Altini S, Baghianimoghadam B, Bahrami-Freiduni M, Esmaeilnejad-Ganji SM, Hajiahmadi M, et al. The outcome measure of proximal humerus fracture treated by open reduction and internal fixation with proximal humerus internal locking system based on oxford shoulder score. Int J Health Sci. 2022 Sep;16(5):49.
18. Walter N, Szymski D, Riedl M, Kurtz SM, Alt V, Lowenberg DW, et al. Proximal humerus fractures in the elderly US population: a cross-sectional study of treatment trends and comparison of complication rates after joint replacement, open reduction and internal fixation, and non-surgical management. J Clin Med. 2023 May 17;12(10):3506.
19. Patel YC, Majumdar S, Shah K, Lathiya H, Bhadani A. Study of outcome of proximal humerus fracture treated with proximal humerus internal locking system (Philos) plating. Int J Orthop. 2023;9(2):117-26.
20. Makiwara K, Takegami Y, Tokutake K, Yamauchi K, Hiramatsu Y, Matsuura Y, et al. Risk factors for fracture-related infection after open reduction and internal fixation of proximal humerus fractures: A multicenter retrospective study of 496 fractures (TRON group study). Injury. 2022 Jul 1;53(7):2573-8.
21. Saraf A, Bishnoi S, Parakh NK, Kumar SK, Chaudhary A, Reddy KD. Clinical and Functional Outcomes of Proximal Humerus Internal Locking System Plate Fixation in Proximal Humerus Fractures: A Short-term Follow-up. J Orthop Case Rep. 2025 Sep;15(9):329.
22. Kugashiya M, Pipal RK, Sojitra RP, Shah JV, Pipal DK, Yadav S. Assessment of Clinical and Functional Outcomes of the Proximal Humerus Internal Locking Compression Plate in Different Neer's Types of Proximal Humeral fracture.
23. Yang J, Liu D, Zhang L, Lu Z, Liu T, Tao C. Treatment of humeral shaft fractures: a new minimally-invasive plate osteosynthesis versus open reduction and internal fixation: a case control study. BMC Surg. 2021 Sep 23;21(1):349.
24. Prakashappa TH, Prashantkumar, Avinash P Jayakumar T. Functional outcome of proximal humerus fracture treated with proximil humerus locking comprgs(ron plate in adults: f" prospective study. Int J Orthop Sci. 2020;6(1):553-6.
25. Foruria AM. Plate fixation of proximal humerus fractures: how to get it right and future directions for improvement. Curr Rev Musculoskelet Med. 2023 Oct;16(10):457-69.
26. Le TG, Bui KH, Do HP, Phan NT, Hoang CM, Pham TT, et al. Factors influencing surgical outcomes of fixation with locking plate for three-and four-part proximal humerus fractures in patients aged 50 Years and older. J Hand Microsurg. 2024 Oct 1;16(4):100127.
27. Pagare P, Mahoviya M, Reddy S, Jain N, Chandravanshi Y. Functional Outcome of Fracture Proximal Humerus Treated with Proximal Humerus Internal Locking System (PHILOS) Plating. Journal of Contemporary Clinical Practice. 2025 Feb;11(2):322-330.
28. Dey Hazra RO, Illner J, Szewczyk K, Warnhoff M, Ellwein A, Blach RM, et al. Age-independent clinical outcome in proximal humeral fractures: 2-year results using the example of a precontoured locking plate. J Clin Med. 2022 Jan 14;11(2):408.
29. Shahid MZ, Ullah SI, Khalid M, Shair NA, Mahmood T, Iqbal M. Outcomes in patients with proximal humerus fractures undergoing open reduction and internal fixation with proximal humerus locking plate. J Allama Iqbal Med Coll.:40.
30. Sathavu PP, Kothimbakkam PK, Murugan PB, Mohideen S, Murugesan V, Ranganathan T. Functional and Radiological Outcome of Proximal Humerus Fractures Treated with Proximal Humerus Internal Locking Osteosynthesis System Plating-A Prospective Study. J Orthop Case Rep. 2025 Jun;15(6):294.
31. Harshavardhana V, Varma K, Manoj Kumar A, Arya S, Jadhav PD. Study on functional outcome of proximal Humerus internal locking Osteosynthesis system plating for displaced proximal humerus fractures: A prospective and retrospective study. Int J Orthop Sci. 2019;5:350.
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