A Comparative Analysis Of Functional Recovery After Philos Plating Versus J-Nail For Proximal Humerus Fractures
Year: 2024
Type: article
Abstract: Background: Proximal humerus fractures constitute approximately 5% of all fractures and present a management challenge, especially in displaced cases.While nonoperative approaches are suitable for stable, minimally displaced fractures, surgical intervention is often required for displaced fractures, with various treatment modalities available.Aim: This study aimed to evaluate the union rate, complications, operative risks, and compare clinical functional outcomes between open reduction internal fixation (ORIF) using PHILOS plating and percutaneous fixation with J-Nail in patients with 3 and 4-part proximal humerus fractures.Methodology: Conducted at Dr. D.Y. Patil Medical College, Hospital and Research Centre, Pimpri, Pune from October 2022 to March 2024, the study included 40 patients with 3 and 4-part proximal humerus fractures: 20 treated with PHILOS plating (ORIF) and 20 treated with J-Nail (CRIF).Fractures were classified according to Neer's classification.Patients were followed up for at least 6 months, and functional outcomes were assessed using the Constant-Murley shoulder score.Results: Among the 20 patients treated with PHILOS plating (ORIF), all fractures achieved radiological and clinical union, with an average Constant-Murley score of 85.29 at final follow-up.In the J-Nail group (CRIF) of 20 patients, the average Constant-Murley score at final follow-up was 79.48.Conclusion: In conclusion, our study comparing PHILOS plating and J-Nail fixation for proximal humerus fractures, especially in older and comorbid patients, favors J-Nail fixation due to superior functional outcomes.Despite PHILOS plating's traditional efficacy in achieving union, J-Nail fixation showed significantly better results in our patient cohort, with a mean Constant-Murley score of 79.48 versus 85.29 for PHILOS, indicating improved functional recovery.J-Nail fixation also offers advantages such as smaller incisions, reduced anesthesia needs, less bleeding, and lower overall morbidity, which are crucial for elderly and medically complex patients.Moreover, J-Nail fixation had a lower incidence of complications like stiffness and infection, highlighting its ability to minimize post-operative risks.These findings support prioritizing percutaneous pinning with J-Nail over PHILOS plating for managing proximal humerus fractures in these specific patient groups, aiming to enhance outcomes and patient satisfaction through a minimally invasive surgical approach.
Author: Dr. Anteshwar Birajdar
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4403544471