الفهرس 
BiomechanicsOnly 14 pages are availabe for public view
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Abstract
Proximal humerus fractures can be one of the most devastating entities to
treat(155). The PHILOS plate was designed to improve screw fixation and minimi
ze soft tissue dissection. It attempts to achieve these aims through a combinatio
n of multidirectional locking screws for the head, precontouring of the plate, an
d locking screws in the shaft. The clinical results to date have been mixed.
Therefore, the current work aimed to identify whether patients treated wit
h PHILOS plate fixation have better shoulder functional recovery than those wit
h bone grafts (156).
This prospective comparative study was carried out on 34 proximal hume
ral fracture patients attending the orthopaedic surgery department at Menoufia
University Hospital and Manshyt Elbakry General Hospital. Patients were divid
ed into two equal groups according to the method of orthopaedic fixation they r
eceived. group I were treated by open reduction and internal fixation using a P
HILOS plate. group II were treated by the same method but with a bone graft (1
57).
Summary of our results:
There was no significant difference in baseline characteristics (age, gende
r, and mechanism of injury) between the studied groups.
There was no significant difference in operative data (time from injury to
surgery, operation time, and intraoperative bleeding) between the studied group
s.
Regarding postoperative data in the studied groups, the neck-shaft angle
was significantly higher in group II than in group I (p =0.002) and the time need
ed for fracture healing was significantly lower in group II than in group I (p =0.
003).
There was no significant difference in the type of reduction and >5 mm lo
ss of reduction between the studied groups.
Summary
Regarding the range of motion after surgery, active flexion, extension, int
ernal rotation, external rotation, and abduction were significantly higher in grou
p II than in group I.
Regarding Penn shoulder score in the studied groups, There was no signif
icant difference in pain at rest, pain with normal activities, pain with strenuous a
ctivities, and total pain score between the studied groups. Also, there was no sig
nificant difference in satisfaction scores between the studied groups. However, t
he function score was significantly higher in group II than in group I (p =0.003).
Complications after the operation were significantly higher in group I tha
n in group II (p =0.034).
In conclusion, proximal humerus comminuted fractures can be treated eff
ectively with the use of locking plate fixation combined with an iliac crest bone
graft. This surgical technique can result in satisfactory radiological and function
al outcomes with an acceptable complication rate.