Functional Outcome of Displaced Proximal Humerus Fractures Managed by Proximal Humerus Interlocking System Plate

Background: Proximal humerus fractures are common, especially in the elderly, and often result from low-energy falls or high-energy trauma in younger patients. These fractures pose a management challenge due to varied patterns and complex anatomy.While many are treated conservatively, displaced or comminuted fractures often require surgical fixation. Locking plates,particularly the proximal humeral internal locking system (PHILOS), offer stable fixation and improved outcomes, especially inosteoporotic bone. This study aims to assess the functional outcome of displaced proximal humerus fractures treated with PHILOSplating at a tertiary care teaching hospital in Mumbai, India. Methods: This prospective observational study involved 30 adults with displaced proximal humerus fractures treated with PHILOSplating. After informed consent, patients underwent surgery and standardized postoperative rehabilitation. Shoulder function wasassessed using the Constant-Murley score (CMS) at 6 weeks, 3 months, and 6 months. Data were analyzed using t-tests and chi-squaretests. Results were expressed as mean ± standard deviation (SD) and percentages, with significance set at P < 0.05. Results: This study included 30 patients (mean age: 52.5 years); 70% were men. Most injuries were due to road traffic accidents (RTAs)(70%), with two-part fractures being most common (60%). Radiological union occurred at 6-8 weeks in 80%, 9-12 weeks in 16.7%, andafter 12 weeks in 3.3% of patients. The CMS improved significantly over 6 months (P < 0.0001). Functional outcomes were good to fairin most patients. Postoperative complications occurred in 36.67%, mainly shoulder stiffness (23.33%), followed by impingement (10%)and malreduction (3.33%). Conclusion: The PHILOS plate offers stable fixation and favorable functional outcomes in proximal humerus fractures, with timelyunion and improved CMS, making it an effective option despite minor complications.