Is Anterior Reversed Proximal Humeral Locking Plate System (PHILOS) a Safe Alternative to Conventional Posterior Double Plating in Extra-Articular Distal Shaft Humeral Fractures
Is Anterior Reversed Proximal Humeral Locking Plate System (PHILOS) a Safe Alternative to Conventional Posterior Double Plating in Extra-Articular Distal Shaft Humeral Fractures: A Randomized Controlled Trial
Extra-articular distal-third humeral shaft fractures are difficult to treat because stable fixation must be achieved while minimizing soft-tissue injury and the risk of nerve damage. Posterior double plating is a commonly used technique but requires extensive surgical exposure and routine handling of the radial and ulnar nerves. Anterior reversed proximal humeral locking plate system (PHILOS) fixation has emerged as a potential alternative that may provide adequate stability with less soft-tissue disruption.
This randomized controlled trial compares anterior reversed PHILOS plating with conventional posterior double plating in adult patients with extra-articular distal-third humeral shaft fractures. The study evaluates functional outcome using the Mayo Elbow Performance Score (MEPS) as primary outcome. Sexondary outcomes include: fracture union, operative parameters, range of motion, and complications including nerve injury, infection, and postoperative stiffness.
調査の概要
研究の種類
入学 (推定)
段階
- 適用できない
連絡先と場所
研究場所
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Cairo、エジプト
- Trauma and Orthopedic department, Faculty of Medicine, Cairo University
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参加基準
適格基準
就学可能な年齢
- 大人
- 高齢者
健康ボランティアの受け入れ
説明
Inclusion Criteria:
- Adults aged 18 years or older.
- Acute extra-articular distal humeral shaft fracture.
- AO/OTA type 12-A (simple) or 12-B (wedge) fracture.
- Closed fracture.
- Isolated injury.
- Presentation within 14 days of injury.
- Ability to provide informed consent and comply with follow-up.
Exclusion Criteria:
- Open fractures.
- Pathological fractures.
- Previous surgery on the ipsilateral humerus.
- Polytrauma requiring staged fixation.
- Contraindication to general anesthesia.
- Inability to complete the required follow-up period.
研究計画
研究はどのように設計されていますか？
デザインの詳細
- 主な目的：処理
- 割り当て：ランダム化
- 介入モデル：並列代入
- マスキング：独身
武器と介入
参加者グループ / アーム |
介入・治療 |
|---|---|
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実験的：Anterior Reversed PHILOS Plating
Patients with extra-articular distal-third humeral shaft fractures treated using an anterior approach and fixation with a reversed Proximal Humeral Internal Locking System (PHILOS) plate.
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Fixation of extra-articular distal-third humeral shaft fractures using a reversed proximal humeral internal locking system (PHILOS) plate applied to the anterior surface of the humerus through an anterior approach.
The construct was secured with locking screws proximal and distal to the fracture site.
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実験的：Posterior Double Plating
Patients with extra-articular distal-third humeral shaft fractures treated using a posterior approach and fixation with orthogonal double plates applied medially and posterolaterally.
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Fixation of extra-articular distal-third humeral shaft fractures through a posterior approach using orthogonal double plates applied medially and posterolaterally after fracture reduction.
Both radial and ulnar nerves were identified and protected during the procedure.
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この研究は何を測定していますか？
主要な結果の測定
結果測定 |
メジャーの説明 |
時間枠 |
|---|---|---|
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Mayo Elbow Performance Score (MEPS)
時間枠：24 months after surgery
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pain (45 points), range of motion (20 points), stability (10 points), and daily functional tasks (25 points).
Total maximum score is 100 meaning best outcome and total minimum score is 10 indicating worst outcome
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24 months after surgery
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二次結果の測定
結果測定 |
時間枠 |
|---|---|
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手術時間
時間枠：術中
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術中
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Fracture Union
時間枠：Upto 24 months after surgery
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Upto 24 months after surgery
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Nerve injury complications
時間枠：Immediately postoperative
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Immediately postoperative
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協力者と研究者
スポンサー
研究記録日
主要日程の研究
研究開始 (実際)
一次修了 (実際)
研究の完了 (推定)
試験登録日
最初に提出
QC基準を満たした最初の提出物
最初の投稿 (実際)
学習記録の更新
投稿された最後の更新 (実際)
QC基準を満たした最後の更新が送信されました
最終確認日
詳しくは
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