Functional Outcomes of Proximal Humerus Fractures Treated with Proximal Humerus Internal Locking System (Philos) Plate: A Prospective Observational Study

Jitesh Kumar Dudi, Kapil Dayma, Shiv Kumar Goyal

Abstract: Background: Proximal humerus fractures (PHFs) represent approximately 5-6% of all fractures, with increasing incidence in aging populations. The Proximal Humerus Internal Locking System (PHILOS) plate has emerged as a preferred treatment for displaced PHFs, offering angular stability through locking screw technology. However, outcomes remain variable with reported complication rates. Objective: To evaluate functional outcomes, union rates, and complications in proximal humerus fracture patients treated with PHILOS plate fixation. Methods: Prospective observational study of 50 patients with displaced proximal humerus fractures treated with PHILOS plate at SMS Medical College, Jaipur. Functional outcomes assessed using Constant Score and Disabilities of the Arm, Shoulder and Hand (DASH) Score at 3 weeks, 3 months, and 6 months post-operatively. Radiological assessment evaluated fracture union. Complications documented throughout follow-up. Results: Mean patient age was 56.95±4.17 years, with slight female predominance (54% vs 46% males). Constant Score improved progressively from 29.2 at 3 weeks to 48.6 at 3 months and 71.8 at 6 months (p<0.001). DASH Score decreased from 68.4 to 48.1 to 26.6, indicating 61% functional improvement (p<0.001). Fracture union achieved in 88% (44/50 patients). Intraoperative complications occurred in 18% (9 patients): suture cut-out (6%), metaphyseal comminution (6%), fracture comminution (4%), malreduction (2%). Postoperative infection rate was 12% (4 superficial, 2 deep). Revision surgery required in 10% (5 patients). No significant differences in outcomes based on fracture laterality or hand dominance. Conclusion: PHILOS plate fixation provides reliable treatment for displaced proximal humerus fractures with high union rates (88%) and progressive functional improvement. Mean 6-month Constant Score of 71.8 and DASH Score of 26.6 demonstrate satisfactory functional recovery. While complication rates (18% intraoperative, 12% infection) warrant attention, 90% of patients avoided revision surgery. PHILOS plating represents effective treatment option for displaced PHFs in appropriately selected patients.

Keywords: Proximal Humerus Fracture, PHILOS Plate, Locking Plate, Constant Score, DASH Score, Functional Outcome, Orthopaedic Trauma

How to Cite?: Jitesh Kumar Dudi, Kapil Dayma, Shiv Kumar Goyal, "Functional Outcomes of Proximal Humerus Fractures Treated with Proximal Humerus Internal Locking System (Philos) Plate: A Prospective Observational Study", Volume 14 Issue 12, December 2025, International Journal of Science and Research (IJSR), Pages: 2440-2447, https://www.ijsr.net/getabstract.php?paperid=SR25203204224, DOI: https://dx.dx.doi.org/10.21275/SR25203204224

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