Philos Plating for Proximal Humeral Fractures: Outcome of 41 Consecutive Fixations

Background: Proximal Humeral fractures (PHFs) are a growing concern in older adults. Proximal Humeral Internal Locking System (PHILOS) plate has been designed to overcome the challenges of traditional fixation methods. This study assesses the clinical and radiological outcomes of PHFs treated with PHILOS plate in Nigeria. Methods: A retrospective study on 41 patients with PHFs treated with PHILOS plating between January 2018 and December 2020. Inclusion criteria were adults who had PHFs with complete follow-up data. We evaluated time to radiological union, Neer's shoulder scores, range of motion (ROM) at union and post-operative complications. Data was analyzed using descriptive statistics and chi- square testing with significance set at p ≤ 0.05. Results: Most patients (87.7%) were above 50 years with a female predominance (58.5%). Falls were the most common mechanism of injury (78%). Most fractures were classified as Neer 3- part (65.9%). Radiological union was achieved within 14 weeks in 82.9% patients. At union, 51.2% of patients attained a Neer's score > 89 with flexion and abduction > 160° in 75.6 % and 73.2% respectively. Forty-one percent of patients had subacromial impingement being the most common complication, followed by screw pull-out, superficial infection and reoperation (7.3%). Conclusion: PHILOS plate yields dependable fixation and satisfactory functional outcomes for proximal humeral fractures especially in elderly patients. While there are some complications, the benefits of early union and excellent shoulder function support its use as an effective operative strategy. Long-term follow-up is necessary to better assess the avascular necrosis and implant longevity