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Original Research | Orthopedic | Volume 15 Issue 8, August 2026 | Pages: 624 - 630 | India
A Prospective Study of Surgical Management of Displaced Proximal Humerus Fractures with Interlocking Plating System
Abstract: Introduction: Proximal humerus fractures account for a significant proportion of all fractures, representing a major therapeutic challenge in orthopaedic trauma, especially within aging populations with poor bone quality. The management of displaced, unstable patterns remains highly controversial. Open reduction and internal fixation (ORIF) with the Proximal Humerus Internal Locking System (PHILOS) is increasingly preferred to counter these challenges by offering improved fixed-angle angular stability, reducing screw toggle risk, and optimizing functional recovery. Aim of the study: To evaluate the radiological and functional outcomes, as well as the complication profiles, of managing displaced proximal humerus fractures using an interlocking plating system. Materials and Method: This hospital-based prospective study was conducted involving 35 adult patients presenting with acute, closed, displaced Neer two-, three-, or four-part proximal humerus fractures treated via ORIF utilizing the PHILOS fixed-angle interlocking plating system executed through a uniform deltopectoral approach. Collected data included demographic parameters, mechanism of injury, fracture configurations, clinical and radiological union assessments, and postoperative functional updates quantified via the Constant-Murley Score and American Shoulder and Elbow Surgeons (ASES) score. Results: The mean age of the cohort was 51.37±12.23 years, with a distribution consisting of 22 males (62.9%) and 13 females (37.1%). Road traffic accidents (RTA) stood as the leading mechanism of injury (48.6%), and right-sided involvement was noted in 60.0% of cases. Neer three-part fractures represented the most prevalent pattern (48.6%). Complete radiological bone union was successfully achieved in 100% of the patients, exhibiting a mean union time frame of 12.49±1.48 weeks. The functional outcome scores yielded a final mean Constant-Murley score of 76.37±8.23 (with 77.1% grading as good-to-excellent) and a mean ASES score of 77.69±8.44. The overall complication rate was limited to 20.0%, occurring exclusively within complex Neer four-part fracture configurations (which showed a subgroup complication rate of 87.5%). Conclusion: The interlocking locking plate system stands as a reliable surgical treatment modality for displaced proximal humerus fractures, offering excellent structural stability, predictable radiological bone union, and optimal functional shoulder recovery. While functional results are excellent in two- and three-part fractures, complex Neer four-part configurations carry a distinctly elevated risk of complications.
Keywords: Proximal Humerus Fracture, Humeral Head, Interlocking Plating System, PHILOS Plate, Constant-Murley Score, Bone Union
How to Cite?: Dr. Devendrappa H, Dr. D Ravikumar, Dr. Divij Anil Mahajan, Dr. Kartik K, Dr. Syed Nasequddin, "A Prospective Study of Surgical Management of Displaced Proximal Humerus Fractures with Interlocking Plating System", Volume 15 Issue 8, August 2026, International Journal of Science and Research (IJSR), Pages: 624-630, https://www.ijsr.net/getabstract.php?paperid=SR26807141553, DOI: https://dx.doi.org/10.21275/SR26807141553