Comparison of Functional Outcome of Proximal Humerus Management with K-Wire versus PHILOS Plate Functional Outcome of Proximal Humerus Management

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Shafqat Wasim
Baqir Jafree
Sherafgan
Asif khan
Shuja Uddin
Aqeel Dhillon

Abstract

Background: Background: Proximal humerus fractures account for approximately 4% of all fractures and 26% of humeral fractures. While conservative treatment is often recommended, surgical management remains debated, particularly with the use of percutaneous pinning and PHILOS plating.
Objective: To compare the functional outcomes of proximal humerus fractures managed with percutaneous pinning versus PHILOS plating using Constant and Murley’s score.
Methods: This prospective, randomized controlled trial was conducted at Services Hospital, Lahore, over 18 months. A total of 128 patients were randomized into two groups: Group A (Percutaneous Pinning, n=64) and Group B (PHILOS Plating, n=64). Demographic data were recorded, and functional outcomes were assessed using Constant and Murley’s score at the 24th week. Data analysis was performed using SPSS 25, with independent t-tests and chi-square tests applied, considering p<0.05 significant.
Results: The mean Constant and Murley score were 84.58 ± 8.561 in Group A and 86.48 ± 7.622 in Group B (p=0.186). Favorable outcomes were seen in 34.4% (n=44) in Group A and 42.2% (n=54) in Group B (p=0.037).
Conclusion: PHILOS plating proved a higher rate of favorable outcomes compared to percutaneous pinning, suggesting its preferable use for proximal humerus fracture management.

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How to Cite
Shafqat Wasim, Baqir Jafree, Sherafgan, Asif khan, Uddin, S., & Aqeel Dhillon. (2024). Comparison of Functional Outcome of Proximal Humerus Management with K-Wire versus PHILOS Plate: Functional Outcome of Proximal Humerus Management. Journal of Health and Rehabilitation Research, 4(3). https://doi.org/10.61919/jhrr.v4i3.1423
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References

Hertel R. Fractures of the Proximal Humerus in Osteoporotic Bone. Osteoporos Int. 2005;16(Suppl 2).

Jaura G, Sikdar J, Singh S. Long-Term Results of PHILOS Plating and Percutaneous K-Wire Fixation in Proximal Humerus Fractures in the Elderly. Malays Orthop J. 2014;8(1):4-7.

Cho CH, Jung GH, Song KS. Tension Suture Fixation Using 2 Washers for Proximal Humeral Fractures. Orthopedics. 2012;35(3):202-205.

Agudelo J, Schürmann M, Stahel P, et al. Analysis of Efficacy and Failure in Proximal Humerus Fractures Treated With Locking Plates. J Orthop Trauma. 2007;21(10):676-681.

Brunner F, Sommer C, Bahrs C, et al. Open Reduction and Internal Fixation of Proximal Humerus Fractures Using a Proximal Humeral Locked Plate: A Prospective Multicenter Analysis. J Orthop Trauma. 2009;23(3):163-172.

Koljonen PA, Fang C, Lau TW, Leung F, Cheung NW. Minimally Invasive Plate Osteosynthesis for Proximal Humeral Fractures. J Orthop Surg. 2015;23(2):160-163.

Fenichel I, Oran A, Burstein G, Pritsch M. Percutaneous Pinning Using Threaded Pins as a Treatment Option for Unstable Two- and Three-Part Fractures of the Proximal Humerus: A Retrospective Study. Int Orthop. 2006;30(3):153-157.

Schumaier A, Grawe B. Proximal Humerus Fractures: Evaluation and Management in the Elderly Patient. Geriatr Orthop Surg Rehabil. 2018;9:2151458517750516.

Kumar A, Waddell JP. Non-Operative Management of Proximal Humerus Fractures. In: Rockwood and Green's Fractures in Adults. 8th ed. Philadelphia: Wolters Kluwer; 2015.

Braunstein V. Two- and Three-Part Fractures. In: Rockwood and Green's Fractures in Adults. 8th ed. Philadelphia: Wolters Kluwer; 2015.

Harrison AK, Gruson KI, Zmistowski B, et al. Intermediate Outcomes Following Percutaneous Fixation of Proximal Humeral Fractures. J Bone Joint Surg Am. 2012;94(13):1223-1228.

Thyagarajan DS, Haridas SJ, Jones D, Dent C, Evans R, Williams R. Functional Outcome Following Proximal Humeral Interlocking System Plating for Displaced Proximal Humeral Fractures. Int J Shoulder Surg. 2009;3(3):57-62.

Chowdary U, Prasad H, Subramanyam PK. Outcome of Locking Compression Plating for Proximal Humeral Fractures: A Prospective Study. J Orthop Surg (Hong Kong). 2014;22(1):4-8.

Ortmaier R, Filzmaier V, Hitzl W, et al. Comparison Between Minimally Invasive Percutaneous Osteosynthesis and Locking Plate Osteosynthesis in 3- and 4-Part Proximal Humerus Fractures. BMC Musculoskelet Disord. 2015;16:297.

Schnetzke M, Bockmeyer J, Loew M, Studier-Fischer S, Grützner PA, Guehring T. Rate of Avascular Necrosis After Fracture Dislocations of the Proximal Humerus: Timing of Surgery. Obere Extrem. 2018;13(4):273-278.

Roux A, Decroocq L, El Batti S, et al. Epidemiology of Proximal Humerus Fractures Managed in a Trauma Center. Orthop Traumatol Surg Res. 2012;98(6):715-719.

Egol KA, Ong CC, Walsh M, et al. Early Complications in Proximal Humerus Fractures (OTA Types 11) Treated With Locked Plates. J Orthop Trauma. 2008;22(3):159-164.

Gardner MJ, Weil Y, Barker JU, et al. The Importance of Medial Support in Locked Plating of Proximal Humerus Fractures. J Orthop Trauma. 2007;21(3):185-191.

Moonot P, Ashwood N, Hamlet M. Early Results for Treatment of Three- and Four-Part Fractures of the Proximal Humerus Using the PHILOS Plate System. J Bone Joint Surg Br. 2007;89(9):1206-1209.

Tamimi I, Montesa G, Collado F, et al. Displaced Proximal Humeral Fractures: When Is Surgery Necessary? Injury. 2015;46(10):1921-1929.