Abstracts - Chirurgie Kongress

General Surgery – Trauma 07
7.1
PHILOS ® : 5 years of experience - has the fracture of the proximal humerus finally been “solved”?
C. Spross, A. Platz, T. Lattmann, J. Forberger, B. Martens, M. Dietrich (Zürich)
Objective: With the first published results of new implants, which provide angular stability for complex
fractures of the proximal humerus, a euphoric spirit was felt among many trauma surgeons. Especially
in osteoporotic bone, these implants seemed to break the mythos of the “unsolved” fracture. In our collective
of patients treated with PHILOS ® we asserted a discrepancy between excellent clinical results,
and a not negligible amount of patients with complications and operative revisions in follow up. Now,
we focused on the latter group in this study.
Methods: Prospective study, single institution case series. All patients, treated with PHILOS ® due to
traumatic fracture of the proximal humerus from 2003 until July 2008 entered the study. Clinical, radiological
and functional follow up was performed at our institution.
Results: The study included 315 (238 female, 77 male) patients. The median age was 73 (21-97) years.
According to the AO 145 (46%) fractures were classified 11-C, 122 (39%) 11-B and 48 (15%) 11-A. We
documented 93 (29.5%) defined complications. Due to lack of clinical restrictions no further intervention
was required in 21 (6.5%) cases. However 72 (23%) patients suffered from complications for which
operative revision was advised. A total of 22 (7%) secondary arthroplasties were recommended, most
of those (n=16, 5%) caused by avascular necrosis (avn). Partial or total hardware removal was mostly
indicated due to 23 (6%) cut outs, 11 (3%) subacromial impingements and 6 (2%) implant failures. Ctype
fractures were significantly (p