上腕骨近位端骨折に対するPHILOSの治療成績

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The purpose of this study was to evaluate the short term results of internal fixation, using PHILOS (Proximal Humeral Internal Locking System), for proximal humeral fractures.We studied 31 shoulders of 30 patients who underwent internal fixation using PHILOS from June 2006 to June 2010. There were 14 male and 16 female patients. One female patient had bilateral proximal humeral fractures. The average age at operation was 65.1 years old (range, 17 to 92). According to the Neers classification, there was one 1-part fracture, thirteen 2-part fractures, seven 3-part fractures, two 4-part fractures, and five fracture-dislocations. Three fractures were unclassifiable by the Neers classification. The mean follow-up period was 12.6 months. The average JOA score was 82.4 points. The mean active flexion was 121°, external rotation was 35°, internal rotation was L2 vertebral level. There were some complications; there were 4 cases of varus displacement, 2 cases of penetration of the proximal screw, 1 case of the screw backing out, 1 case of osteonecrosis, and 1 case of deep infection. There were no neurovascular complications.We performed internal fixation using PHILOS for proximal humeral fractures and got satisfactory outcomes in most cases. PHILOS might be a better alternative for 3 or 4-part fracture/ fracture-dislocation and articular surface fracture that had been indicated for hemiarthroplasty. To prevent varus displacement after surgery, we have to achieve a mechanical support of the inferomedial region of the proximal humerus during operation.

上腕骨近位端骨折に対するPHILOSの治療成績

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