Assessment of Functional Outcome and Post-Perative Complications Following Treatment of Roximal Humerus Fractures With Philos Plating Ixation: a Retrospective Study

Abstract

Background: Proximal humerus fractures (PHFs) are common, particularly among middle-aged and elderly individuals, and their surgical management remains challenging due to variable fracture patterns, bone quality, and complication risk. The Proximal Humerus Internal Locking System (PHILOS) plate is widely used for fixation, but functional and complication outcomes reported in the literature remain variable and are especially scarce in our study setting and geographical area. Aim: To assess the functional outcomes and post-operative complications in patients undergoing treatment of PHFs with PHILOS plate fixation. Methods: This is a retrospective study assessed the records of 35 patients with PHFs managed with PHILOS plating fixation. Demographic details, mechanism of injury, and fracture morphology (Neer classification) were recorded. Functional outcome was assessed and graded as excellent, satisfactory, unsatisfactory, or failure, and post-operative complications were documented. Results: The mean age of patient was 54.8 ± 15.9 years, with males comprising 60.0% of the cohort. Falls were the predominant mechanism of injury (57.1%), and 2-part fractures were the most common fracture pattern (42.9%). Overall, 77.1% of patients achieved excellent or satisfactory functional outcomes, while 17.1% had unsatisfactory outcomes and 5.7% experienced treatment failure. Functional outcome did not differ significantly according to fracture type (χ² = 6.840, p = 0.336). Post-operative complications were observed in 17.1% of patients, most commonly stiffness (8.6%), followed by varus malunion (5.7%) and superficial infection (2.9%). Although complications increased with fracture complexity, the association was not statistically significant (χ² = 7.578, p = 0.271). Conclusion: PHILOS fixation is an effective treatment option for PHFs, particularly in achieving satisfactory functional outcomes with a relatively low complication burden.