Long Term Results of PHILOS Plating and Percutaneous K-Wire Fixation in Proximal Humerus Fractures in The Elderly

This is a report of a study on the long term results of PHILOS plating and percutaneous K-wire fixation in a prospective series of proximal humerus fractures in elderly patients. We reviewed a total of 60 patients with proximal humerus fractures in 30 patients (Group 1), who were treated by open reduction and internal fixation with Proximal Humeral Internal Locking System (PHILOS) plate and 30 patients (Group 2) who were treated with percutaneous K-wire fixation. Functional outcome was assessed using Visual Analogue Scale(VAS) and Constant-Murley Score. Mean Constant-Murley score was 84.6 points (range: 61-100) in Group 1 and - 76.4 points(range:56-100) in Group 2 at final follow up. Values varied depending upon the fracture type with worst in 4-part fractures. Mean VAS Score was 2.6(range:0-10) in Group 1 and 3.8(range:0-10) in Group 2. We obtained satisfactory results in both the groups, with each procedure having its advantages and shortcomings. We found that PHILOS plate fixation provided stable fixation with minimal implant problems and enabled early range-of-motion exercises to achieve acceptable functional results. Fixation with percutaneous K-wires presented an efficient treatment option with the advantages of minimal invasiveness and soft tissue dissection.