ArticleOrthopaedic surgery2019
Comparison of the Effects of Proximal Humeral Internal Locking System (PHILOS) Alone and PHILOS Combined with Fibular Allograft in the Treatment of Neer Three- or Four-part Proximal Humerus Fractures in the Elderly.
Article in Orthopaedic surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 6 of them syntheses that pooled it.
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Who cites it
27 citing papers in PubMed, 6 syntheses or guidelines pooled it, 57 citations in OpenAlex.
- The effects of augmentation choices for locking plate fixation in proximal humerus fracture osteosynthesis: a systematic review and meta-analysis.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2025Pooled it
- Reverse total shoulder arthroplasty versus locked plate fixation for proximal humeral fractures in the elderly: a systematic review.PloS one · 2025Pooled it
- Risk factors for osteonecrosis of the humeral head after internal fixation of proximal humeral fractures: a systematic review and meta-analysis.Archives of orthopaedic and trauma surgery · 2024Pooled it
- Quality of Life and Pain after Proximal Humeral Fractures in the Elderly: A Systematic Review.Medicina (Kaunas, Lithuania) · 2023Pooled it
- Effects of fibular strut augmentation for the open reduction and internal fixation of proximal humeral fractures: a systematic review and meta-analysis.Journal of orthopaedic surgery and research · 2022Pooled it
- Interventions for treating proximal humeral fractures in adults.The Cochrane database of systematic reviews · 2022Pooled it
- Influence of allograft augmentation on surgical outcomes and complications in proximal humerus fractures: a matched-pair analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026Article
- A biomechanical comparison of fibular strut and femoral head allograft for augmented locking plate fixation in three-part proximal humerus fractures.JSES international · 2026Article
- Evaluating the outcomes of PHILOS with allogeneic fibular support for treating Neer type III and IV proximal humeral fractures with associated glenohumeral dislocation in elderly patients.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Proximal humerus fractures in the elderly: is there (still) a role for plate osteosynthesis?European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025Review
- Retrospective analysis of open reduction and locking plate fixation in three and four part proximal humeral fractures with efficacy and complications.Scientific reports · 2025Article
- Clinico-radiological outcomes of four-part proximal humerus fracture fixation with fibular strut graft augmentation.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2025Article
- Functional Outcome of Proximal Humerus Internal Locking System (PHILOS) Plating in Proximal Humerus Fractures.Cureus · 2025Article
- Bone grafting augmentation choices in complex proximal humerus fractures: A systematic review.Journal of orthopaedics · 2025Review
- Novel Use of a Fibular Strut Allograft with Fibular Head in an Elderly Patient with Proximal Humeral Fracture and Severe Metaphyseal Comminution: An Alternative to Shoulder Arthroplasty.Journal of clinical medicine · 2024Article
- Fibula allograft in complex three-part and four-part proximal humeral fractures in active patients, a matched case-control study.JSES international · 2024Article
- Treatment of proximal humeral fractures accompanied by medial calcar fractures using fibular autografts: A retrospective, comparative cohort study.World journal of clinical cases · 2023Article
- An Analysis of the Morphology of Bony Bicipital Groove Fractures in Proximal Humeral Fractures.Orthopaedic surgery · 2023Article
- The effect of integrity of lesser tuberosity-medial calcar on postoperative outcome in the proximal humeral fracture.Journal of orthopaedic surgery and research · 2023Article
- Intrinsic Cortical Property Analysis of the Medial Column of Proximal Humerus.Orthopaedic surgery · 2023Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo compare and analyze the clinical outcomes of the proximal humeral internal locking system (PHILOS) alone and the PHILOS combined with fibular allograft in the treatment of Neer three- and four-part proximal humerus fractures (PHF) in the elderly.
methodsFrom January 2014 to January 2018, a total of 42 elderly patients with Neer three- or four-part PHF admitted to our hospital were randomly divided into observation group and control group, with 21 patients in each group. The observation group was treated with the PHILOS combined with fibular allograft. The control group was treated with the PHILOS alone. Perioperative parameters and fracture classification were recorded in the two groups. Function results were assessed by Visual Analog Scale (VAS), Constant-Murley score (CMS), American Shoulder and Elbow Surgeons (ASES) score, and the Disability of Arm-Shoulder-Hand (DASH) score. Radiological results were evaluated using the neck-shaft angle (NSA) and humeral head height (HHH), and complications were also recorded in each group.
resultsThere were no significant differences between the two groups in terms of preoperative status, age, gender, cause of trauma, fracture site, and fracture classification. The average follow-up time was 12 months. At the last follow-up, the VAS and DASH observation groups were lower than the control group, and there was significant difference between the two groups (P < 0.05). The CMS and ASES were higher in the observation group than the control group, and there was significant difference between the two groups (P < 0.05). The mean difference in the NSA and HHH were lower in the observation group than the control group, and there was a significant difference between the two groups (P < 0.05). There was one postoperative complication in the observation group, which was humeral head avascular necrosis (AVN). There were seven postoperative complications in the control group, including three cases of humeral head collapse and three cases of screw cutout and one case of humeral head AVN. The incidence of postoperative complications in the observation group was significantly lower than the control group (P < 0.05), there was a significant difference between the two groups.
conclusionsFor Neer three- or four-part PHF in the elderly patients, PHILOS fixation with fibular allograft shows satisfactory short-term results with respect to humeral head support and maintenance of reduction, and may reduce the incidence of complications associated with fixation using a PHILOS alone.
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