OBJECTIVETo study clinical effects of PHILOS (proximal humeral internal locking system) plates through mini-open deltoid-splitting approach for the treatment of proximal humeral fractures.

METHODSFrom March 2006 to August 2010, 22 patients with proximal humeral fractures were treated with PHILOS plates through mini-open deltoid-splitting approach. According to Neer classification, 6 cases were type II, 15 cases were type III and 1 case was type IV. Through the anterolateral approach to the shoulder, anterolateral vertical incision of 4 cm length was perforrmed from 1 cm under acromion, and separated deltoideus muscle vertically to touch the fracture,reduced the end of fracture directly and indirectly. PHILOS plate was inserted downward into anterolateral surface of humerus through deltoideus muscle, the distal end and proximal end was fixed by locking screws. The Neer score for shoulder function was evaluated within 1 year after operation.

RESULTSThe operative time ranged from 30 to 70 minutes with an average of 45 minutes. No blood transfusion was required during the operation, and all incisions healed in stage I. All the patients were followed up, and the duration ranged from 6 to 18 months with a mean time of 12.5 months. All the fractures healed up perfectly, and the union time ranged from 6 to 12 weeks. According to Neer criteria for shoulder joint function, 10 patients got an excellent result, 9 good, 2 poor and 1 bad. There were no complications such as axillary nerve injuries, screw loosening, steel plate breakage, dislocation of shoulder joint and necrosis of humeral bone.

CONCLUSIONPHILOS plate through mini-open deltoid-splittin approach for the treatment of proximal humeral fractures has follow advantages: simple recover,minor-injuries and small tissue invasion, which is an ideal method to treat proximal humeral fractures.