EVALUATION OF CLINICAL, RADIOLOGICAL, AND POSTOPERATIVE OUTCOMES IN PROXIMAL HUMERUS FRACTURES MANAGED WITH PHILOS PLATE OSTEOSYNTHESIS

Abstract

: Background: Proximal humerus fracture is one of the most common fracture in orthopaedic practice especially in adults with osteoporotic and high energy trauma. The surgical treatment of displaced fractures with Proximal Humeral Internal Locking System (PHILOS) provides angular stability, early mobilisation and attempts to achieve satisfactory functional and radiological results. Objective: To assess functional and radiological results and associated postoperative complications in patients with proximal humerus fractures treated with fixation with PHILOS plates. Materials and Methods: This prospective clinical study was carried out in the Department of Orthopaedics, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, from March 2025 to February 2026. Thirty adult patients aged 18-50 years with displaced proximal humerus fractures were included in the study. All patients were treated with open reduction and internal fixation with the PHILOS plate using the standard deltopectoral approach. Fractures were classified according to the Neer classification. Patients were followed up clinically and radiologically, and functional outcome was assessed using the Constant-Murley Shoulder Score. Radiological union and postoperative complications were evaluated as well. Results: The majority of patients (40%) belonged to age group 41-50 years followed by 31-40 years (30%). According to Neer’s classification, 60% of patients had two-part fractures, 30% had three-part fractures and 10% had four-part fractures. The functional assessment showed good results in 17 patients (56.66%), fair results in 12 patients (40%) and poor results in one patient (3.34%). Radiological evaluation showed excellent results in 12 patients (40%) satisfactory result in 15 patients (50%) unsatisfactory result in 3 patients (10%) and no radiological failure. PHILOS plating provided stable fracture fixation and satisfactory clinical recovery with an acceptable complication profile overall. Conclusion: The PHILOS plate fixation is a safe and effective surgical option for the treatment of displaced proximal humerus fractures. It gives stable fixation, satisfactory fracture healing, early rehabilitation and good functional and radiological results with low rate of postoperative complications . Careful surgical technique and structured rehabilitation are needed to obtain the best possible clinical results.