PHILOS Plate Plus Oblique Insertion of Autologous Fibula for 2-Part Proximal Humerus Fractures With Medial Column Disruption: A Retrospective Study

Ying Shu; Meiji Chen; Weiguang Yu; Zhe Ge; Hao Hu; Xinchao Zhang; Xianshang Zeng; Xiangzhen Liu

doi:10.1177/2151459321992666

PHILOS Plate Plus Oblique Insertion of Autologous Fibula for 2-Part Proximal Humerus Fractures With Medial Column Disruption: A Retrospective Study

Geriatr Orthop Surg Rehabil. 2021 Mar 4:12:2151459321992666. doi: 10.1177/2151459321992666. eCollection 2021.

Authors

Ying Shu^{1

2}, Meiji Chen^{3

2}, Weiguang Yu⁴, Zhe Ge⁵, Hao Hu¹, Xinchao Zhang⁵, Xianshang Zeng⁴, Xiangzhen Liu⁶

Affiliations

¹ Department of Anesthesiology, Wuhan Fourth Hospital; Puai Hospital, Tongji Medical College, Huazhong University of Science and Technology, Qiaokou District, Wuhan, China.
² Ying Shu and Meiji Chen contributed equally to this work.
³ Department of Pediatrics, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China.
⁴ Department of Orthopaedics, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China.
⁵ Department of Orthopaedics, Jinshan Hospital, Fudan University, Jinshan District, Shanghai, China.
⁶ Department of Oral and Maxillofacial Surgery, The First Affiliated Hospital, Sun Yat-sen University, Yuexiu District, Guangzhou, China.

Abstract

Introduction: The aim of this retrospective study was to evaluate the outcomes of older patients with 2-part proximal humerus fractures (PHFs) with medial column disruption stabilized using a proximal humeral internal locking system (PHILOS) plate plus oblique insertion of autologous fibula as a primary procedure.

Materials and methods: Data involving 112 patients (112 shoulders) sustaining 2-part PHFs with medial column disruption treated with PHILOS plate plus oblique insertion of autologous fibula as a primary procedure during 2012-2019 were identified. The median follow-up was 36 months (range: 11.2-43.5 months). The primary endpoint was the Constant scores and American Shoulder and Elbow Surgeons (ASES) scores. The secondary endpoint was the main orthopedic complication rate.

Results: The median Constant and ASES scores were 78 (range, 52-95) and 77 (range, 62-96) at the final follow-up, respectively. The main orthopedic complication rate was 10.7% (12/112). Twelve orthopedic complications in 8 patients were detected, and they involved loss of reduction, varus collapse, aseptic loosening, mal-union, revision, and intolerable shoulder pain. Of these complications, 3 (2.6%) involved loss of reduction, 2 (1.7%) involved varus collapse, 3 (2.6%) involved aseptic loosening, 1 (0.8%) involved mal-union, 2 (1.7%) required revision surgery, and 1 (0.8%) presented intolerable shoulder pain.

Conclusion: PHILOS plate plus oblique insertion of autologous fibula as a primary procedure may yield good functional outcomes and a low rate of the main orthopedic complications.

Keywords: autologous fibula; displaced; osteosynthesis; outcome; proximal humerus fracture.