The versatility of the proximal humeral internal locking system plate in orthopedic surgery: A comprehensive review of its off-label applications

The proximal internal locking system (PHILOS) plate is widely recognized in orthopedic surgery for treating proximal humerus fractures, offering early functional recovery and improved patient outcomes. However, its applications have expanded beyond the proximal humerus. This narrative review aimed to evaluate the unconventional use of this technique in fracture fixation across various anatomical regions, including the periprosthetic area, the distal humerus, the proximal and distal femur, and the distal tibia. It examines both successful and unsuccessful clinical outcomes, highlighting its role as an alternative solution in urgent situations, particularly when standard implants are unavailable. This review may guide future treatment strategies and surgical decision-making in orthopedic practice by providing insights into its versatility.