ArticleCureus2026
Functional and Radiological Outcomes of Displaced Proximal Humerus Fractures Treated With the Proximal Humerus Internal Locking System (PHILOS) Plate: A Prospective Single-Center Observational Study.
Article in Cureus, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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4 authors.
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Abstract
Background Angular-stable fixation with the proximal humerus internal locking system (PHILOS) is widely used for displaced proximal humerus fractures. We prospectively evaluated its functional and radiological outcomes over 24 weeks at a tertiary-care center. Methodology Forty-three adults with proximal humerus fractures considered to require operative fixation underwent open reduction and internal fixation with a PHILOS plate. Pain (visual analog scale, VAS) and shoulder function (Constant-Murley score, CMS) were assessed at two, six, 12, and 24 weeks; time to union and immediate post-operative neck-shaft angle (NSA) and humeral head height were recorded. Serial change was analyzed with the Friedman test and, as confirmation, Greenhouse-Geisser-corrected repeated-measures analysis of variance (ANOVA), with Bonferroni-adjusted Wilcoxon post-hoc comparisons. Results Mean age was 48.0 ± 14.4 years (32 men, 11 women); all 43 patients completed follow-up. Mean total CMS rose from 40.7 ± 1.7 at 2 weeks to 54.3 ± 2.6, 66.6 ± 3.3 and 76.1 ± 3.6 at 6, 12 and 24 weeks (Friedman χ² = 129.0, p < 0.001; repeated-measures ANOVA p < 0.001). Mean VAS fell from 9.1 ± 0.6 pre-operatively to 1.2 ± 0.4 at 24 weeks (p < 0.001); all pairwise interval comparisons were significant (p < 0.001). At 24 weeks, 18.6% of shoulders were graded excellent, 79.1% good, and 2.3% fair. All fractures united (mean 9.8 ± 2.6 weeks). Final CMS was lower with higher Neer grade (p = 0.007) and increasing age (ρ = -0.35, p = 0.02). Immediate post-operative NSA (133 ± 3°) and head height (8.7 ± 1.3 mm) were within accepted limits. Conclusions PHILOS fixation produced progressive, statistically significant improvements in pain and shoulder function, with a 100% union rate over 24 weeks; outcomes were poorer in older patients and in patients with more complex fractures. The single-center design, the absence of a comparison group, and the mid-term follow-up limit generalisability, and longer follow-up is needed to capture late complications such as avascular necrosis.
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