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Long-term follow-up after MIPO Philos plating for proximal humerus fractures

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Introduction

Minimally invasive plate osteosynthesis (MIPO) has been described as a suitable technique for the treatment of proximal humerus fractures, but long-term functional results have never been reported. The aim of this study was to describe the long-term functional outcome and implant-related irritation after MIPO for proximal humerus fractures.

Methods

A long-term prospective cohort analysis was performed on all patients treated for a proximal humerus fracture using MIPO with a Philos plate (Synthes, Switzerland) between December 2007 and October 2010. The primary outcome was the QuickDASH score. Secondary outcome measures were the subjective shoulder value (SSV), implant related irritation and implant removal.

Results

Seventy-nine out of 97 patients (81%) with a mean age of 59 years were available for follow-up. The mean follow-up was 8.3 years (SD 0.8). The mean QuickDASH score was 5.6 (SD 14). The mean SSV was 92 (SD 11). Forty out of 79 patients (50.6%) had implant removal, and of those, 27/40 (67.5%) were due to implant-related irritation. On average, the implant was removed after 1.2 years (SD 0.5). In bivariate analysis, there was an association between the AO classification and the QuickDASH (p = 0.008).

Conclusion

Treatment of proximal humerus fractures using MIPO with Philos through a deltoid split approach showed promising results. A good function can be assumed due to the excellent scores of patient oriented questionnaires. However, about one-third of the patients will have a second operation for implant removal due to implant-related irritation.

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Acknowledgements

The authors thank Simone Kindle, study nurse, for her efforts in contacting and questioning all patients. They also thank Michelle Reynolds for the excellent copy-editing of this manuscript.

Funding

There was no external source of funding for this study.

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Authors and Affiliations

  1. Department of Trauma Surgery, Kantonsspital Graubünden, Loëstrasse 170, 7000, Chur, Switzerland

    H. Frima, C. Michelitsch & C. Sommer

  2. Utrecht Traumacenter, Universitair Medisch Centrum Utrecht, Heidelberglaan 100, 3584 CX, Utrecht, The Netherlands

    R. B. Beks & R. M. Houwert

  3. Department of Orthopaedic Surgery, Kantonsspital Baselland, 4101, Bruderholz, Switzerland

    Y. P. Acklin

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  1. H. Frima
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  2. C. Michelitsch
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Correspondence to H. Frima.

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Conflict of interest

Herman Frima, Christian Michelitsch, Reinier B. Beks, Roderick M. Houwert, Yves P. Acklin and Christoph Sommer declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Frima, H., Michelitsch, C., Beks, R.B. et al. Long-term follow-up after MIPO Philos plating for proximal humerus fractures. Arch Orthop Trauma Surg 139, 203–209 (2019). https://doi.org/10.1007/s00402-018-3063-1

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