Reversed Proximal Humerus Internal Locking System(RPHILOS) plate for distal Humerus shaft fractures through posterior approach

Abstract

Humeral shaft fractures account for approximately 2% of all fractures in adults with almost 30% of them being located in the distal third.Extra-articular distal third humeral fractures are difficult to treat due to small distal fragment, which prevents from using enough screws and more stiffness. There is still some debate over which implant is best for rigid fixation. We described the application of PHILOS plate in reversed manner through posterior approach. A 20years old male presented in emergency department with right Humerus fracture while doing arm wrestling. After following the ATLS protocol, patient’s fracture was fixed using a PHILOS plate in upside down manner on the posterior surface of Humerus by using posterior approach. Patient was kept in Poly sling for 2 weeks. Full range of motion was achieved at 3 weeks. We Concluded that reversed PHILOS is safe and effective technique in the treatment of extra-articular fracture of distal Humerus by using posterior approach.