STUDY OF MANAGEMENT OF PROXIMAL HUMERUS FRACTURE BY PHILOS PLATE AND ITS OUTCOME

Background: Fractures of the proximal humerus are frequently encountered injuries,arising from low-energy trauma in the elderly and high-energy trauma among the younger population. These fractures can result in considerable morbidity and functional limitations. Different methods of fixation have been employed, and among them, the PHILOS plate has gained prominence as the preferred implant for addressing displaced and comminuted proximal humerus fractures. Despite this, a degree of debate persists regarding the optimal approach to treatment. Methodology: This prospective observational study was carried out with the goal of assessing the functional outcomes of PHILOS plates for the management of proximal humerus fractures.The research involved a cohort of 30 adult patients who underwent open reduction and internal fixation through the implementation of the PHILOS plate at a tertiary care medical center.Followup evaluations were conducted over a minimum duration of 1 year,and the assessment of patient outcomes was executed using the Constant Murley score. Results: The patient cohort exhibited an average age spanning from 20 to 80 years, with a male-to-female ratio of 4:1. Most fractures were 3-part fractures (60%), followed by 2-part and 4-part fractures (20% each). Road traffic accidents were the most common mode of trauma (66.66%), and the right side was predominantly affected. Postoperative complications included shoulder stiffness (23.33%) and postoperative wound infection (10%), while varus collapse/malunion occurred in 6.66% of cases. Overall, the PHILOS plate yielded good functional outcomes, with 73.33% of patients achieving good results and 6.66% having excellent outcomes. Conclusion: The study demonstrates that internal fixation and open reduction with the help of a PHILOS plate offer stable fixation, early mobilization, and good functional outcomes for displaced and comminute proximal humerus fractures. The proper clinical evaluation, accurate anatomical restoration, and aggressive rehabilitation regime are essential for successful outcomes.The PHILOS plate serves as a reliable implant for treating such fractures and ensuring better functional results.