Proximal humerus fractures operated with PHILOS plate: 4 year prospective study

Background: Fractures of proximal humerus are still an unsolved problem in many ways. Locked plating is becoming more common; precise knowledge of and experience with the surgical technique is required to maximize clinical outcomes. However the goal of proximal humerus fracture fixation should be stable reduction allowing early mobilization. This study is conducted to study the results and complications of proximal humeral fractures treated by anatomic locking compression plate (PHILOS- proximal humerus interlocking system) and PHLP- Pro.Methods: This is a 4 year prospective study, conducted in the department of Orthopaedics in Shri B M Patil Medical College & Hospital, Vijaypur. Displaced two part, three part and four part fractures of proximal humerus with or without shoulder dislocation including fractures involving osteopenic bone were included. The functional assessment was done according to constant Murley score and DASH score at the end of 6 months.Results: Out of 60 patients, 56 were available for follow-up: 24 patients having excellent results (4 are 2 part, 20 are 3 part fractures), 32 patients having good results (22 are 3 part, 10 are 4 part fractures).  None of the patients had fair or poor results. Conclusions: In conclusion, the internal fixation of proximal humeral fractures with the use of anatomic locking compression plates yields reliable results when utilized correctly. We believe that, provided the correct surgical technique is used by competent surgeon, the anatomic locking compression plate is suitable for the stabilization of proximal humeral fractures and can lead to a good functional outcome

Clinical outcome of treatment of intra-articular distal humerus fracture with open reduction and internal fixation by orthogonal locking plate: a prospective study

Background: The aim of the study was to study the clinical outcome and complications of surgical management of intra-articular fractures of distal humerus.Methods: A prospective study included 23 consented patients with intra-articular distal humeral fractures who underwent osteosynthesis by orthogonal locking compression plating using posterior approach with olecranon osteotomy between November 2017 to May 2019 at BLDE(DU’s) Shri BM Patil Medical College, Vijayapura, Karnataka.Results: In our study there were 15 male patients and 8 female patients with mean age of 38.5 years. 65.2% of the cases admitted were due to motor vehicle accident, 21.7% due to accidental fall and 13% due to fall from height with right side (73.9%) being the more commonly affected side. The mean operative time was 100 minutes. Mayo Elbow Performance Score was 83.3% post operatively and the mean arc of motion was 117°. 82% of cases fared excellent to good results.Conclusions: Orthogonal locking plate construct provides stable rigid fixation for allowing early mobilisation and allows predictable healing both clinically and functionally in these complicated fractures. Absence of implant failure and non-union may be attributed to the highly stable construct system achieved by orthogonal locking plating. Majority of our cases had good functional outcome and return to pre injury status

Functional Outcome of Acute Minimally Displaced Scaphoid Waist Fractures Treated with Percutaneous Headless Compression Screw Fixation: A Prospective Cohort Study

Introduction: Scaphoid fracture incidence has increased recently due to increased participation of people in sports and increased road traffic accidents and easy availability of diagnostic tools like Computed Tomography (CT), which help in easily diagnosing scaphoid fractures, and may be missed on routine radiographs. Aim: To evaluate the functional outcome of surgical intervention with percutaneous headless compression screw fixation for acute minimally displaced scaphoid fractures. Materials and Methods: The present study was a prospective cohort study in which patients with acute fractures of scaphoid bone managed with percutaneous headless compression screw fixation were included between January 2020 to December 2022 and were evaluated using the Modified Mayo Wrist Score (MMWS) and Disabilities of Arm, Shoulder and Hand (DASH) score. The data obtained was entered into a Microsoft Excel sheet, and statistical analysis was performed using a Statistical Package for the Social Sciences (SPSS) version 20.0. Results: The study included 55 patients with a mean age of 32.9 years, out of which 43 were males and 12 were females. Road traffic accident injuries were in 19 patients, 17 were sports injuries and 19 were due to direct trauma. All patients were managed by percutaneous headless compression screw fixation. Among these, 27 patients showed excellent outcomes, 24 showed good outcomes, and four showed fair outcomes. Conclusion: This study shows that percutaneous fixation of minimally displaced scaphoid fractures results in early symptomatic relief and functional recovery. It shows that percutaneous fixation using a headless compression screw has similar functional outcomes and less hospital stay and patient scarring than in open fixation methods. Functional recovery is faster with percutaneous fixation than in non operative and open fixation