The use of locking plates in proximal humeral fractures: Comparison of outcome by patient age and fracture pattern

Purpose: This study was undertaken to evaluate the efficacy of a proximal humeral locking plate, and to specifically study the effect of patient age and fracture type on the outcome. Materials and Methods: Thirty-one cases of proximal humeral fractures fixed by using the proximal humeral interlocking (PHILOS) plate were reviewed. Results: Average functional scores (minimum 18 months post operation) per AO / ASIF fracture type were 25.3 for type A, 21.4 for type B, and 22.7 for type C. There was no statistically significant difference between the groups. The functional scores for patients over 65 years of age were significantly inferior (P = 0.03). At a final radiological review (mean 12 months post operation), 30 (96%) of the patients demonstrated fracture union. Seven patients (22.5%) required a second surgical procedure. Conclusion: We obtained both good functional results and bone healing with the PHILOS plate, irrespective of fracture type; the older patients had a poorer outcome. We caution the surgeons on the high potential for reoperations with its use.