Comparison of the efficacy of the PHILOS plate and the hook plate in the treatment of isolated humeral greater tuberosity split fractures

Introduction: This study aimed at comparing the efficacy of the PHILOS plate and the hook plate for the treatment of the isolate split greater tuberosity fracture of humerus. Methods: All patients with isolate split humeral greater tuberosity fractures that were treated using PHILOS plate or hook plate from January 2018 to June 2021 were retrospectively investigated. Data on the above-mentioned patient demographics, injury characteristics, preoperative and postoperative imaging, length of incision, operative time, intraoperative blood loss, and outcomes were recorded and then investigated. Furthermore, the inclusion criteria and exclusion criteria were formulated. Results: A total of 193 patients were diagnosed with proximal humerus fractures in our institution,and 31 patients conformed to the inclusion criteria. In accordance with the different fixed methods, the patients fell into two groups. To be specific, 19 patients in group A were administrated with PHILOS (proximal humeral internal locking system) plate, and 12 patients in group B were administrated with hook plate. No significant difference was identified in sex, age, injury mechanism, dominant side limb (yes or no), shoulder joint dislocation (yes or no) between two groups. However, in Group B, the operative time was shorter, blood loss was less, length of incision was shorter than Group A's Moreover, pain was evaluated at third day and fifth day after surgery, the pain in fifth day was less in group B than group A, pain in third day and last follow up was no difference between two groups. The constant score, the DASH score, the ROM were evaluated at the last follow up, no significant difference was identified between two groups. The complications were also collected, five patients administrated with PHILOS plate were diagnosed subacromial impact, and two patients administrated with hook plate were diagnosed rotator cuff injury. Conclusion: The hook plate can achieve favorable results in the treatment of isolate split humeral greater tubercle fractures, with less blood loss, shorter operative time and shorter surgical incisions than the PHILOS plate.