A study of functional outcome of traumatic fracture dislocation of the proximal humerus managed with proximal humerus internal locking system (PHILOS) plating: A case series

Abstract

Background: The shoulder is the most commonly affected major joint in cases of fracture-dislocation, typically involving fractures of the surgical neck and/or the greater tuberosity of the proximal humerus. The study aims to assess the functional and radiological outcomes using the Proximal Humerus Internal Locking System (PHILOS) in patients of proximal humerus fracture-dislocations. Materials and methods: This prospective observational study included 20 patients with proximal humeral fracture-dislocations treated and fallow up between July 2023 to July 2025. All patients were the age of 18-60 years. Open reduction and internal fixation (ORIF) using the PHILOS locking plate system was performed in all patients later underwent a standardized rehabilitation protocol. Clinical outcomes were assessed using the Constant–Murley Score (CMS) and the Disabilities of the Arm, Shoulder and Hand (DASH) score at 6 weeks, 3 months, 9 months and 12 months. Results: The mean Constant–Murley Score at final follow-up was 83.4±3.2, and the mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 12.6±1.9, indicating favourable functional outcomes. No complications were noted in 16 patients (80%). 2 patient (10%) developed subacromial impingement and another 2 patient (10%) showed radiographic evidence of post-traumatic arthritis. Serial assessment of the DASH score demonstrated consistent improvement over time from a mean of 69.0±3.16 at 6 weeks to 12.6±1.9 at 12 months, reflecting progressive functional recovery. Conclusion: Open reduction and internal fixation using locking plates provides favourable functional outcomes with a low complication rate in patients with proximal humeral fracture-dislocations, even in anatomically complex cases. Level of evidence: Level IV; Case Series; Prospective observational Study