Percutaneous transdeltoid osteosynthesis for proximal humeral fractures with the proximal humeral internal locking system plate

Purpose
This study was designed to evaluate clinical outcomes and complications following minimally invasive plate osteosynthesis (MIPO) with the proximal humeral internal locking system (PHILOS) for treating proximal humeral shaft fracture.
Patients and methods
Between March 2012 and March 2013, 37 patients with unilateral proximal humeral shaft fractures were treated using the MIPO technique with the PHILOS through the transdeltoid approach. All fractures were closed with no associated injuries and classified as two part (=13), three part (=19), and four part (=5), according to the Neer’s classification. Patients were followed-up for 16.9 months (range, 12–24 months), radiologically and functionally. Postoperative complications and functional constant shoulder score was used.
Results
No intraoperative complications occurred. Postoperative complications included subacromial impingement in three patients. There was no deep infection, neurovascular damage, breakage, or implant loosening. All fractures united in an average time of 10 weeks (8–12 weeks). In terms of function, the Constant–Murley score was 89 points on average (range, 75–100 points). The range of motion of the involved shoulder was satisfactory, and pain-free in 84% of patients.
Conclusion
Using the MIPO technique with the PHILOS plate through the transdeltoid approach is a valid and safe method of treating proximal humeral shaft fractures.