• Skip to main content
  • Skip to primary sidebar
  • Skip to footer
  • General Ortho
  • Procedures
  • Spine
  • Upper Limb
  • Lower Limb
  • Pain
  • Trauma
  • Tumors
  • Newsletter/Updates
  • About Us
  • Contact Us

Bone and Spine

Orthopedic health, conditions and treatment

PHILOS or Proximal Humerus Internal Locking System

By Dr Arun Pal Singh

PHILOS stand for Proximal Humerus internal locking system. It is an anatomic fixation 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 this system provides stability and reduces the number of complications.

It is a precontoured plate and broader on the proximal part than distal. Here is an image of the system.

PHILOS
Proximal Humerus Internal Locking System

Proximal Humerus Internal Locking System is used for fixation of upper humeral injuries and is indicated in

  • Dislocated two-, three-, and four-fragment fractures of the proximal humerus, including fractures involving osteopenic bones

The plate 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 pure titanium and implant steel.

The plate is contraindicated in acute infections and children during the growth phase.

The proximal Humerus Internal Locking System is put using deltopectoral or transdeltoid approach after temporary reduction and fixation with sutures and k-wires.

The plate 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 pertinent that PHILOS is placed well. Also, the plate is centered laterally against the greater tubercle, ensuring that a sufficient gap is maintained between the plate and the long biceps.

fracture dislocation shoulder operated with PHILOS
Postopertive Film showing Reduced Shoulder and Fracture Fixed With PHILOS

If PHILOS is not available standard plates like modified cloverleaf plate are an option though there is some evidence that angular stable plate provides better outcomes.

The fixation provided by PHILOS is strong and allows early mobilization of the affected joint.

 

 

Spread the Knowledge
  • 7
    Shares
  •  
    7
    Shares
  •  
  • 7
  •  
  •  
  •  

Filed Under: General Ortho

About Dr Arun Pal Singh

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. He works in Kanwar Bone and Spine Clinic, Dasuya, Hoshiarpur, Punjab.

This website is an effort to educate and support people and medical personnel on orthopedic issues and musculoskeletal health.

You can follow him on Facebook, Linkedin and Twitter

Reader Interactions

Leave a Reply Cancel reply

Your email address will not be published. Required fields are marked *

This site uses Akismet to reduce spam. Learn how your comment data is processed.

Primary Sidebar

Ruptured Distal Biceps Tendon

Biceps Tendon Rupture

Biceps tendon rupture may occur in the proximal part of the biceps muscle or distal. Proximal biceps tendon rupture accounts for 97% of all biceps ruptures and typically occurs at the bony attachment or tendon labral junction. The long head of the biceps is vulnerable as it travels through the shoulder joint. Fortunately, the biceps […]

Scheuermann Kyphosis

Scheuermann Kyphosis

Scheuermann disease or  Scheuermann kyphosis is a self-limiting disorder of the childhood. In this condition where the vertebrae grow unevenly resulting in the wedge-shaped vertebrae, resulting in kyphosis. Patients have an increased kyphosis in the thoracic or thoracolumbar spine with associated backache and localized changes in the vertebral bodies. Typically, the kyphosis is more pronounced […]

Measurement of Q-angle

Q Angle Measurement and Significance

Q angle is the angle formed by a line drawn from the anterosuperior iliac spine to the central patella and a second line drawn from central patella to tibial tubercle Patellofemoral joint biomechanics is influenced by the direction and magnitude of force exerted by quadriceps muscle.  In a normal knee, the line of force exerted […]

Pseudogout - chondrocalcinosis

Pseudogout and Calcium Pyrophosphate Deposition Disease

Overview of Terms The term pseudogout, calcium pyrophosphate deposition disease are considered as synonyms. Though used synonymously these terms denote different meanings should be understood before we discuss the disease further. Calcium Pyrophosphate Deposition Disease Calcium pyrophosphate deposition disease is a disease due to deposition of calcium pyrophosphate crystals in the body. It can manifest […]

Drugs for Tuberculosis

Drugs For Tuberculosis

First Line Drugs For Tuberculosis There are five drugs in the first-line attack against tuberculosis. The drugs differ in their mechanism of action; whether they are bactericidal i.e. kill bacteria rapidly or bacteriostatic i.e. inhibits the multiplication and growth of bacteria but do not kill them. They also differ in their action against intracellular bacilli […]

Pediatric Glasgow Coma Scale

Glasgow coma Scale and Pediatric Glasgow Coma Scale

Glasgow Coma Scale Glasgow Coma Scale is a neurological scale developed by Teasdale and Jennett and is also known as Glasgow Coma Score. Glasgow coma scale is used to record consciousness levels of the person. Glasgow coma scale is routinely used in head injuries and other central nervous system conditions The scale comprises three tests: […]

Watson jones approach of hip

Surgical Approaches to Hip and Proximal Femur

For surgery, the hip can be approached by many surgical approaches. The choice of particular approach is based on the procedure and need for exposure of a particular part, associated shaft or acetabular fixation and the preference of the surgeon. There are numerous approaches and some are modifications of original approaches. Most of the approaches […]

Browse Articles

Footer

Pages

  • About
    • Policies
    • Contact Us

Featured Article

Cubital Tunnel Syndrome – Presentation and Treatment

Cubital tunnel syndrome is the second most common peripheral nerve entrapment syndrome in the human body. It is the cause of considerable pain and … [Read More...] about Cubital Tunnel Syndrome – Presentation and Treatment

Search Articles

© Copyright: BoneAndSpine.com