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Outcomes following fracture fixation with the Equinoxe® proximal humerus plate: an improvement over PHILOS®?

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Introduction

The purpose of this study is to compare patient outcomes between the Equinoxe® (Exactech, Gainesville, Fla) proximal humerus locking plate and the PHILOS® (Synthes, Paoli, PA) proximal humerus locking plate.

Methods

Two hundred and seventy-one patients with a displaced proximal humerus fracture presented to our academic medical center between February 2003 and October 2020. Functional outcomes assessed included the Disabilities of the Arm, Shoulder, and Hand questionnaire and shoulder range of motion. Radiographs were utilized to determine fracture healing and development of posttraumatic osteoarthritis or osteonecrosis.

Results

Overall, 108 Equinoxe® and 87 PHILOS® patients treated by a single surgeon with complete clinical, functional, and radiographic follow-up were included in the study. Demographics were similar between groups. One hundred and eight Equinoxe® patients healed at a mean time to union by 3.7 ± 2.2 months, and 86 PHILOS® patients healed (p = 0.24) by 4.1 ± 2.3 months after surgery (p = 0.31). Shoulder external rotation was greater in Equinoxe® patients by 7 degrees (p = 0.044), and forward elevation was greater by 16 degrees (p = 0.005) at one-year follow-up. DASH scores were similar between patients at the 3-, 6-, and 12-month follow-up (p = 0.86, p = 0.77, p = 0.64). Fewer Equinoxe® patients experienced complications (p = 0.043).

Conclusion

Fixation of a proximal humerus fracture can safely be performed with both Equinoxe® and PHILOS® proximal humerus locking plates. Patients fixed with Equinoxe® plates achieved a slightly greater degree of external rotation, forward elevation, and experienced fewer complications. This difference may be due to surgeon experience rather than the implant itself.

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Data availability

All data presented comply with journal standards. Upon request, authors are prepared to send relevant documentation or data in order to verify the validity of the results presented.

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Funding

There was no source of funding for this study.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, NYU Langone Health, NYU Langone Orthopedic Hospital, 301 E 17th Street, Suite 1402, New York, NY, 10003, USA

    Connor P. Littlefield, Jack H. Drake & Kenneth A. Egol

Authors
  1. Connor P. Littlefield
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  2. Jack H. Drake
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  3. Kenneth A. Egol
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Contributions

Kenneth Egol contributed to the study conception and design and manuscript revising and editing. Material preparation, data collection and analysis, and initial manuscript drafting were performed by Jack Drake and Connor Littlefield. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Kenneth A. Egol.

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Conflict of interest

*Kenneth A Egol, MD, is a committee member of the Orthopaedic Trauma Association, a paid consultant for and Surgeon-designer for Exactech, a paid speaker for Smith and Nephew, and receives research support or publishing royalties from Acumed, Synthes, SLACK Incorporated, and Wolters Kluwer. The remaining authors declare no conflict of interest.

Ethical approval

This study was approved by the NYU School of Medicine Institutional Review Board.

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Informed consent was obtained from all individual participants included in the study.

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Littlefield, C.P., Drake, J.H. & Egol, K.A. Outcomes following fracture fixation with the Equinoxe® proximal humerus plate: an improvement over PHILOS®?. Eur J Orthop Surg Traumatol 32, 733–738 (2022). https://doi.org/10.1007/s00590-021-03036-7

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  • DOI: https://doi.org/10.1007/s00590-021-03036-7

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