PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis
Purpose: The aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis. Methods: A comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane databases u...
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| Format: | Article |
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MDPI AG
2022-02-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/12/2/311 |
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| author | Lorenzo Massimo Oldrini Pietro Feltri Jacopo Albanese Francesco Marbach Giuseppe Filardo Christian Candrian |
| author_facet | Lorenzo Massimo Oldrini Pietro Feltri Jacopo Albanese Francesco Marbach Giuseppe Filardo Christian Candrian |
| author_sort | Lorenzo Massimo Oldrini |
| collection | DOAJ |
| description | Purpose: The aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis. Methods: A comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane databases up to 7 October 2021. Studies describing medium and long-term complications in PHF synthesis using the PHILOS plate were included. A systematic review and meta-analysis were performed on complications and causes of reinterventions. Assessment of risk of bias and quality of evidence was performed with the Downs and Black’s “Checklist for Measuring Quality”. Results: Seventy-six studies including 4200 patients met the inclusion criteria. The complication rate was 23.8%, and the main cause was screw cut-out (4.1%), followed by avascular necrosis (AVN) (3.1%) and subacromial impingement (1.5%). In patients over 55 years, the complication rate was 29.5%. In the deltopectoral (DP) approach the complication rate was 23.8%, and in the delto-split (DS) it was 17.5%, but no difference between the two approaches was seen when considering the type of fracture. The overall reintervention rate was 10.5% in the overall population and 19.0% in older patients. Conclusions: Proximal humerus synthesis with a PHILOS plate has high complications and reintervention rates. The most frequent complication was screw cut-out, followed by humeral head AVN and subacromial impingement. These results need to be further investigated to better understand both the type of patient and fracture that is more at risk of complications and reintervention and to compare pros and cons of the PHILOS plate with respect to the other solutions to manage PHFs. |
| first_indexed | 2024-03-09T21:34:03Z |
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| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-09T21:34:03Z |
| publishDate | 2022-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-1d8218bf9624475e9c548c6f267c0fcd2023-11-23T20:47:20ZengMDPI AGLife2075-17292022-02-0112231110.3390/life12020311PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-AnalysisLorenzo Massimo Oldrini0Pietro Feltri1Jacopo Albanese2Francesco Marbach3Giuseppe Filardo4Christian Candrian5Service of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, SwitzerlandService of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, SwitzerlandService of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, SwitzerlandService of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, SwitzerlandService of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, SwitzerlandService of Orthopaedics and Traumatology, Department of Surgery, EOC, 6900 Lugano, SwitzerlandPurpose: The aim of this study was to quantify the rate of complications and reinterventions in patients treated with PHILOS plate for proximal humerus fractures (PHFs) synthesis. Methods: A comprehensive literature search was performed on the PubMed, Web of Science, Embase, and Cochrane databases up to 7 October 2021. Studies describing medium and long-term complications in PHF synthesis using the PHILOS plate were included. A systematic review and meta-analysis were performed on complications and causes of reinterventions. Assessment of risk of bias and quality of evidence was performed with the Downs and Black’s “Checklist for Measuring Quality”. Results: Seventy-six studies including 4200 patients met the inclusion criteria. The complication rate was 23.8%, and the main cause was screw cut-out (4.1%), followed by avascular necrosis (AVN) (3.1%) and subacromial impingement (1.5%). In patients over 55 years, the complication rate was 29.5%. In the deltopectoral (DP) approach the complication rate was 23.8%, and in the delto-split (DS) it was 17.5%, but no difference between the two approaches was seen when considering the type of fracture. The overall reintervention rate was 10.5% in the overall population and 19.0% in older patients. Conclusions: Proximal humerus synthesis with a PHILOS plate has high complications and reintervention rates. The most frequent complication was screw cut-out, followed by humeral head AVN and subacromial impingement. These results need to be further investigated to better understand both the type of patient and fracture that is more at risk of complications and reintervention and to compare pros and cons of the PHILOS plate with respect to the other solutions to manage PHFs.https://www.mdpi.com/2075-1729/12/2/311PHILOSlocking plateproximal humeral fracturePHFosteosynthesis |
| spellingShingle | Lorenzo Massimo Oldrini Pietro Feltri Jacopo Albanese Francesco Marbach Giuseppe Filardo Christian Candrian PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis Life PHILOS locking plate proximal humeral fracture PHF osteosynthesis |
| title | PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis |
| title_full | PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis |
| title_fullStr | PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis |
| title_full_unstemmed | PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis |
| title_short | PHILOS Synthesis for Proximal Humerus Fractures Has High Complications and Reintervention Rates: A Systematic Review and Meta-Analysis |
| title_sort | philos synthesis for proximal humerus fractures has high complications and reintervention rates a systematic review and meta analysis |
| topic | PHILOS locking plate proximal humeral fracture PHF osteosynthesis |
| url | https://www.mdpi.com/2075-1729/12/2/311 |
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