Displaced proximal humeral fractures are common fractures with high complication rate especially in osteoporotic elderly population. The purpose of our clinical prospective case series was to evaluate the Philos locking plate developed by AO/ASIF in surgical treatment of these difficult fractures.

Between October 2005 and March 2007 42 patients were included in the study group. The patients were divided in two groups based on the age at the time of presentation. Group A consisted of patients younger than 65 years old; 14 male, 9 female; mean age 43.8 (24–63 years old) and group B were patients above the age 65; 16 female, 3 male; mean age 77.3(66–90 years old). All fractures were classified according to AO/ASIF classification and radilogical and functional outcomes were assesed.

Mean follow up was 7.8 months. The mean Constant scres were 86.3(71–92) in group A and 84.7(68–92) in group B (p> 0.05). All fracture healed uneventfully and no implant failure was observed. Displacement of tuberculum majus fragment was observed in only one case. Avascular necrosis of the humeral was not observed in any case.

This prospective study proved that when technical details are followed and supplementary suture fixation of the tubercular fragments to the plate is obtained locking plate fixation of these problem fractures in every age group has a very high radiological and functional success rate. Especially in fixation of osteoporotic fractures lack of fixation failure and initiation of early range of motion is a major advantage.