Author's personal copy Mid-term results of internal fixation of proximal humeral fractures with the Philos plate

The proximal humeral fractures account for 5-9% of all fractures and mostly affect elderly osteoporotic patients with highest incidence among women in the ninth decade. The purpose of this study is to analyse our experience from the use of the Philos 1 plate (Synthes, Paoli, PA, USA), for the treatment of three-and four-part proximal humeral fractures. In addition, we aim to investigate the exact indications and contraindications of this implant and recognise the effect various patient factors, fracture patterns and specific technical details have on the final clinical outcome. Results: Healing of the fracture occurred uneventfully within 6 months. In three patients, humeral head collapsed due to aseptic necrosis after fracture healing and the plate had to be removed in two cases. In one patient, fracture healing occurred in >108 varus displacement. The clinical result according to the Constant-Murley score was 86 points (range: 58-112). Conclusions: Internal fixation with the Philos plate seems to be a reliable option in the operative treatment of upper end humeral fractures, especially in osteoporotic bone. It allows secure fracture fixation and quick shoulder mobilisation, while quick and uneventful fracture healing and very satisfactory clinical results are achieved. ß Patients and methods Betwee