Using PHILOS plate through anterolateral acromial approach for treating proximal humerus fractures in elderly patients

CHEN Xiao-jun; HE Zhi-yu; ZOU Yong-gen; LUO Cheng; WU Jian

doi:10.3969/j.issn.1009-4237.2016.08.014

Abstract：Objective To investigate the clinical significance of using proximal humeral internal locking system ( PHILOS) plate through anterolateral acromial approach for treatment of proximal humerus fractures in eld -erly patients with minimally invasive plate osteosynthesis (MIPO) technique.Methods From Apr.2012 to Apr. 2014,26 cases of proximal humerus fractures were treated with PHILOS plate through anterolateral acromial ap -proach with MIPO technique.There were 11 males and 15 females with an average age of 67.8 years (range,60-82 years) and with an average time of 4.1 days after injury(range,2-14 days) between injury and operation,including 6 cases of Neer Ⅱ,11 cases of Neer Ⅲ,and 9 cases of Neer Ⅳ.The operation time ,operative blood loss ,length of follow-up,healing time and Neer score were recorded .Results All cases experienced a primary wound healing ,a mean operation time of 85 min (range,50-115 min),and a mean intraoperative blood loss of 90mL (range,60-140mL).All the 26 cases were followed up for 6 to 18 months with an average of 9.5 months.The bone healing time was 15.8 weeks(range,11-29 weeks).According to Neer scores,the functional results of the shoulder were e-valuated within 1 year after operation ,were classified as excellent in 10 cases,good in 13 cases,fair in 2 cases,and poor in 1 case.The excellent and good rate was 88.5%.Conclusion Using PHILOS plate through anterolateral acromial approach for treatment of proximal humerus fractures in elderly patients with MIPO technique has advanta -ges of less trauma , less blood loss , shorter operative time , rapid recovery of shoulder joint function and fracture . When the procedure is performed with the lateral double incision , preservation of the axillary nerve is necessary . This approach can be the first choice for closed proximal humerus fracture but more extensive studies are needed ,es-pecially to elderly patients with osteoporosis .