Preliminary clinical and radiographic outcomes of proximal humeral fractures: comparison of ALPS and PHILOS plating in Asian patients in Taiwan.
BACKGROUND
Up to 20% of proximal humeral fractures need to be treated operatively. However, numerus complications were reported by using fixed angled locking plates. The ALPS Proximal Humerus Plating System is a new design implant with novel design features. The aim of this study was to compare the preliminary clinical outcomes and complications of proximal humeral fractures treated with either ALPS or the proximal humeral internal locking system (PHILOS) in Asian patients in Taiwan.


METHODS
Between January 2016 and December 2018, 66 patients with displaced proximal humeral fractures were analyzed retrospectively, of whom 31 underwent ALPS implant treatment and 35 underwent PHILOS implant treatment. Intraoperative blood loss and operation time, postoperative Constant-Murley Shoulder Outcome (Constant-Murley) score, and complications variables were recorded for the comparison. All cases were regularly followed up for at least 1 year.


RESULTS
The mean follow-up period was 400.8 days (range, 367-446 days). Union was achieved in 98.5% of patients (65/66). The ALPS group yielded similar radiologic and clinical outcomes to the PHILOS plating group for treating displaced proximal humeral fractures, including operation time, intraoperative blood loss, the Constant-Murley score, and varus malunion (P > 0.05, respectively). However, the incidence of total postoperative complications in the ALPS group was significantly lower than in the PHILOS group (P < 0.05). There was a trend of a lower complication rate of screws/pegs protrusion, avascular necrosis, subacromial impingement, postoperative infection, and reoperation in the ALPS group, although it was not statistically significant (P > 0.05, respectively).


CONCLUSION
The ALPS group yielded similar radiologic and clinical outcomes to the PHILOS plating group for displaced proximal humeral fractures, but the ALPS group had a significantly lower total rate of complications. Therefore, ALPS may be a better option for treating proximal humeral fractures. Further larger clinical studies are needed to confirm the findings presented here.


TRIAL REGISTRATION
Retrospective study.
['Chen|Chun-Yen|CY|', 'Chang|Hao-Wei|HW|', 'Hsieh|Shang-Lin|SL|', 'Chang|Chien-Chun|CC|', 'Tsai|Chun-Hao|CH|', 'Chen|Yi-Wen|YW|', 'Lin|Tsung-Li|TL|', 'Hsu|Chin-Jung|CJ|http://orcid.org/0000-0002-8747-8490']
D044466:Asians D001860:Bone Plates D005500:Follow-Up Studies D005593:Fracture Fixation, Internal D006801:Humans D011183:Postoperative Complications D011474:Prosthesis Design D012189:Retrospective Studies D012784:Shoulder Fractures D013624:Taiwan D013997:Time Factors D016896:Treatment Outcome
Asian patient Complication Proximal humerus ALPS locking plate Fracture fixation PHILOS locking plate Treatment outcome