PHILOS stand for Proximal Humerus internal locking system. It is an anatomic ?xation system for the proximal humerus which also provides angular stability. This plate was designed with an eye on eldery people as their bones are osteoporotic. A fixation with PHILOS provide stability and reduces number of complications.
It is a precontoured plate and broader on proximal part than distal. Here is an image of PHILOS.
PHILOS is used for fixation of upper humeral injuries. PHILOS is indicated in
- Dislocated two-, three-, and four-fragment fractures of the proximal humerus, including fractures involving osteopenic bones
PHILOS comes in two lengths. One is 90 mm long and has 3 holes . Long PHILOS has a length of 140-270 mm and contains 5, 6, 8, 10, and 12 elongated holes in the shaft.
It has 9 proximal screw holes. It is available in in pure titanium and implant steel.
PHILOS plate is contraindicated in acute infections and children during growth phase.
PHILOS is available in pure titanium and implant steel.
The PHILOS is put using deltopectoral or transdeltoid approach after temporary reduction and fixation with sutures and kwires.
PHIOLS is positioned at least 8 mm distal to the upper end of the greater tubercle. Roughly it is the insertion od rotator cuff. Placing the plate at too high a level increases the risk of subacromial impingement. Placing the plate too low can prevent the optimal distribution of screws in the humerus head.
Therefore it is pertnient that PHILOS is placed well. Also, the plate is centered laterally against the greater tubercle, ensuring that a suf?cient gap is maintained between the plate and the long biceps.
If PHILOS is not avialable standard plates like modified cloverleaf plate are an option though there is some evidence that angular stable plate provide better outcomes.
The fixation provided by PHILOS is strong and allows early mobilization of the affected joint.
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