Comparison of Open Reduction and Internal Fixation with PHILOS Plate versus Close Reduction and Fixation with Percutaneous K-wiring in Proximal Humerus Fractures

Introduction: Fractures of the proximal humerus are the most common injuries in the upper limbs, especially in the elderly. Surgical options are available, including open reduction and PHILOS plating, as well as K-wire percutaneously reduced fixation, each with its advantages and disadvantages. Objectives: The study aims to discuss the clinical and functional outcomes of plate fixation using the PHILOS plate compared to K-wire fixation of proximal humerus fractures. Materials and Methods: This was a randomised controlled trial involving 144 patients treated at the Department of Orthopaedics, Allama Iqbal Teaching Hospital, DG Khan, between February 2024 to November 2024. The patients were separated into two categories, Group A (plating using PHILOS) and Group B (K-wire fixation). The result was evaluated using Neer's scoring system after 12 weeks. Results: Group A rated significantly higher in functional outcome, with 48.6% achieving an excellent outcome, compared to 27.8% in Group B. Complication rates were low in the PHILOS group. Conclusion: PHILOS plating represents a better functional outcome and fewer complications than the K-wire in the fixation of the proximal humerus fractures in the displaced proximal humerus fractures.