Correlation of Central Column Diaphyseal Angle, Humeral Head Height, Greater Tuberosity to Articular Surface Distance, Age and Fracture Pattern with Constant Murley Score Functional Outcomes in Post-ORIF PHILOS Patients with Proximal Humerus Fracture

Introduction: Proximal humerus fractures (PHF) are common injuries, particularly in the elderly population, caused by both direct and indirect trauma. The Proximal Humerus Internal Locking System (PHILOS) is a widely used treatment for displaced or complex PHF. To assess shoulder function, the European Society for Surgery of the Shoulder and the Elbow recommends the Constant–Murley Score (CMS) as a reliable tool for evaluating shoulder joint outcomes. Materials and Methods: This cross-sectional study was conducted at RSUP Prof I.G.N.G. Ngoerah, Denpasar, Bali, between May 2024 and July 2024. Descriptive analysis was used to determine patient characteristics. The relationships between Central Column Diaphyseal Angle (CCDA), Humeral Head Height (HHH), Greater Tuberosity to Articular Surface Distance (GT-ASD), and CMS were analyzed using Pearson correlation for normally distributed data and Spearman correlation for non-normal data. Results: Statistically significant relationships were found between CCDA, HHH, and GT-ASD with the CMS in patients who underwent ORIF PHILOS for proximal humerus fractures (r=0.915; p<0.001). A significant correlation was also observed between fracture pattern and CMS outcomes. However, age did not show a significant relationship with CMS. Conclusion: CCDA with a cutoff of 109.5 degrees was identified as a primary predictor of functional outcomes. HHH and GT-ASD were also significant, indicating the importance of anatomical restoration for shoulder function recovery. Age did not affect CMS outcomes, emphasizing that the quality of anatomical reconstruction is more critical than age in predicting functional recovery post-surgery. Keywords: CCDA, HHH, GT, AS, Fracture Pattern, Constant Murley Score