Clinical Observations For Proximal Humerus Fractures Of The Old Patients Treated With Philos

Purpose： The aim of this study was to assess the clinical efficacy ofthe old patients who had undergone open reduction and internal fxationwith PHILOS Plate fxation following fracture of the proximal humerus.Methods：A retrospective study was performed on35patients withproximal humerus fracture over the age of sixty who had been treated byPHILOS plate fxation between March2011and March2013in ourhospital, including13males and22females. The average patient age was69.5years old (range62to82years). In all cases studied, there were33fresh and closed fractures which received surgery3to5days after injury.After one month of conservative treatment, aggravated fragmentdisplacement of fracture occurred in2cases. According to the Neerclassification,8cases were two-part fracture,21cases were three-partfracture, and6cases were four-part fracture. Constant-Murley Score andNeer system was used to evaluate the clinical effects by judging theshoulder joint function. Results：All patients were carried out a follow-up of12to24months,average18months. Two patients developed axillary paralysis after surgerybut both recovered within four weeks regardless of treatment. One patientexperienced humeral head necrosis while with feel-good shoulder jointfunctions so as to receive no treatment. X ray reexaminations showed clinicfracture healing3months after surgery and bony union6months aftersurgery in35cases. There was no internal fixation loosening or screwperforations occurred. One year postoperatively, all patients were evaluatedusing the Neer system.23cases were excellent,8cases were good,2caseswere moderate,2cases were poor, and the excellent and good rate was88.57%. According to the Constant-Murley Score, excellent outcomes wereachieved in25cases, good outcomes in5cases, moderate outcomes in3cases, poor outcomes in2cases, with an excellent and good outcome rateof85.71%.Conclusions：Internal fxation using PHILOS plate is a reliablemethod of treating fracture of proximal humerus. It provides a stablefxation and allow early shoulder mobilisation. The functional outcome issatisfactory with minor complications.