European Journal of Molecular & Clinical Medicine

Approximately 80-85 percent of proximal humeral fractures were treated non-operatively, resulting in good functional results. Where it is noted that significant displacement was associated with poor functional outcome, especially in communicated fractures, as in the 15% to 20% of displaced proximal humerus fractures, thus moving to surgical fixation for better results. In the proposed study a minimum of 30 cases presenting with proximal humeral fractures were evaluated clinically and radio logically. The fractures were classified by using Neer’s classification.
Routine investigations will be carried out in order to get fitness for surgery. Consent of the patient will be taken. The final results are evaluated by using NEER’S Score. In our study the minimum score was 72 and maximum of 94. The average score is 82.93. We had excellent results in 7 (23%) of patients, 14(46%) had satisfactory results, 9(30%) patients had unsatisfactory results but none of the case is failure in our study.

Most fractures of proximal humerus occur through osteoporotic bones in older patients. High energy trauma may result in such fractures at any age. Most common mechanism is a simple fall on the arm. Strong muscular contraction is the proposed mechanism for greater Tuberosity fractures. This is seen in cases of electric shock or seizure. Once the fragments separate muscle forces contribute to their displacement. The shaft is generally drawn anteriorly and medially by the pectoralis major. Once the patient is fit for surgery, will under goes open reduction and internal fixation with proximal humerus interlocking system(PHILOS)plate and screws under brachial plexus block or general anesthesia, Patient will be placed in Beach chair. All the patients were approached by Deltopectoral approach, cephalic vein is dissected and retracted, internervous plane between deltoid and biceps tendon. Once fracture site is exposed, fracture is reduced provisionally with K wires and checked in fluoroscopy. And final fixation done with PHILOS plate and position is confirmed in fluoroscopy. The mode of injury commonly observed in our series was road traffic accidents accounting for 23 (76%), 7 (24%) patients had a history of fall. These observations was found to be consistent with the studies in literature which revealed 19 (45%) road traffic accidents, 20(50%) history of fall.

Background: The proximal humerus fractures are not easy to handle and are the second most
common fractures of the upper extremity. The aim of the study is to analyze the treatment
outcome of proximal humerus fractures using Philos Plate.
Methods: The present study included 40 patients from May 2019 to May 2021 who
underwent PHILOS plate fixation for displaced proximal humeral fractures using the
PHILOS plating system in the department of Orthopaedics, IGIMS, Patna.
Results: Patients were followed up for 6 to 18 months. The mean Constant shoulder score
was 75 (range 28–88). 14 patients had a score exceeding 75,11were scored between 50 and
75, and 10 were below50. Constant scores in 2-, 3- and 4-part fractures were compared.
Conclusion: In the present study, PHILOS plate fixation provided stable fixation with
minimal metal work problems and enabled early range-of-motion exercises to achieve
acceptable functional results. However, the choice of treatment should be based on patient
age, functional requirements, bone quality and fracture pattern.