ReviewLife (Basel, Switzerland)2022
PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis.
Review in Life (Basel, Switzerland), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
39 citing papers in PubMed, 2 syntheses or guidelines pooled it, 56 citations in OpenAlex.
- Reverse total shoulder arthroplasty versus locked plate fixation for proximal humeral fractures in the elderly: a systematic review.PloS one · 2025Pooled it
- Comparative efficacy and safety of medical treatments for proximal humerus fractures: a systematic review and network meta-analysis.BMC musculoskeletal disorders · 2024Pooled it
- Antegrade intramedullary nail and plate combination technique for proximal humeral non-union: A case report.Trauma case reports · 2026Article
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- Analysis of factors associated with persistent night pain after locking plate fixation of proximal humerus fractures and development of a prediction model.BMC musculoskeletal disorders · 2026Observational
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- Article
- MIPO versus ORIF with long proximal humerus locking plate for metadiaphyseal proximal humeral fracture.Journal of orthopaedic surgery and research · 2026Article
- External fixation versus reverse shoulder arthroplasty for proximal humerus fractures in the elderly: a retrospective comparative study.Archives of orthopaedic and trauma surgery · 2026Article
- Effect of reduced orbital rotation on image quality and intra-articular screw detection in intraoperative 3D imaging of proximal humerus plate fixation: a cadaveric study.Journal of orthopaedic surgery and research · 2026Article
- ORIF of three- and four-part proximal humeral fractures: a retrospective study of long-term clinical and complication outcomes of two-plate fixation methods.Journal of orthopaedics and traumatology : official journal of the Italian Society of Orthopaedics and Traumatology · 2026Article
- Radiological Outcomes, Complications, and the Influence of Risk Factors in PHILOS Repair of Three- and Four-Part Proximal Humerus Fractures with and Without Femoral Head Allograft: Insights from a Cohort of 116 Patients.Journal of clinical medicine · 2026Article
- Fluoroscopic Evaluation of Reduction and Plate Positioning in Proximal Humerus Fractures: A Case-Control Study Comparing CFR-PEEK and Metallic Plates.The archives of bone and joint surgery · 2026Article
- EVIDENCE-BASED REVIEWS & RECOMMENDATIONS FROM THE BRAZILIAN SOCIETY OF SHOULDER AND ELBOW SURGERY: REVERSE ARTHROPLASTY FOR COMPLEX PROXIMAL HUMERAL FRACTURES IN ELDERLY PATIENTS.Acta ortopedica brasileira · 2026Review
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- Functional and radiological outcomes of percutaneous wiring for two and three part fractures of the proximal humerus.Journal of clinical orthopaedics and trauma · 2025Article
- Preventing reduction loss following proximal humerus fractures after locking compression plate fixation: a new clinical prediction model.BMC musculoskeletal disorders · 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
- Comparison of the efficacy of Philos plate and Multiloc intramedullary nail in the treatment of complex proximal humeral fractures with osteoporosis in the elderly.Frontiers in surgery · 2025Article
- The VIDIA BONE score as a patient- and fracture-related risk score for the occurrence of fracture sequelae in proximal humerus fractures.BMC musculoskeletal disorders · 2024Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis.
methodsA comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane databases up to 7 October 2021. Studies describing medium and long-term complications in PHF synthesis using the PHILOS plate were included. A systematic review and meta-analysis were performed on complications and causes of reinterventions. Assessment of risk of bias and quality of evidence was performed with the Downs and Black's "Checklist for Measuring Quality".
resultsSeventy-six studies including 4200 patients met the inclusion criteria. The complication rate was 23.8%, and the main cause was screw cut-out (4.1%), followed by avascular necrosis (AVN) (3.1%) and subacromial impingement (1.5%). In patients over 55 years, the complication rate was 29.5%. In the deltopectoral (DP) approach the complication rate was 23.8%, and in the delto-split (DS) it was 17.5%, but no difference between the two approaches was seen when considering the type of fracture. The overall reintervention rate was 10.5% in the overall population and 19.0% in older patients.
conclusionsProximal humerus synthesis with a PHILOS plate has high complications and reintervention rates. The most frequent complication was screw cut-out, followed by humeral head AVN and subacromial impingement. These results need to be further investigated to better understand both the type of patient and fracture that is more at risk of complications and reintervention and to compare pros and cons of the PHILOS plate with respect to the other solutions to manage PHFs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.