Reversed proximal humeral internal locking system (PHILOS) plate for distal humeral shaft fractures through an Anterolateral Approach

Background: We described the application of a PHILOS plate in a reversed manner for the treatment of extra-articular distal third humeral fractures through an anterolateral approach. Methods: For the treatment of distal humerus fractures, sixteen patients underwent internal fixation procedures using the reversed (PHILOS) plate between August 2022 and August 2023. Data was collected regarding clinical results, radiological results, and surgical complications. The Mayo and Oxford elbow scores, as well as the elbow's range of motion, were all part of the clinical evaluation. Results: The mean follow-up time was 8 months(range, 6 to 12 months).The average Mayo elbow and Oxford elbow scores were 95.31 (of a total of 100) and 45.31 (of a total of 48), respectively. The mean range of elbow motion was 134.37° (range 130–140). Fracture union was noted in all patients, with an average period of 15.13 weeks. One patient had a superficial wound infection, and another patient post operatively developed radial nerve palsy which completely recovered within 3 months. Conclusion: In extra-articular distal third diaphyseal humeral fractures, a modified anterior application of the PHILOS plate could be a practical choice in fractures within 3 cm from coronoid fossa.