Abstract

Dr. Rajesh Kumar*, Dr. Subham Srivastava, Dr. Abdullah Faizal

ABSTRACT

Background: Proximal humerus fractures are common injuries, particularly in the elderly population, often requiring surgical intervention for displaced fractures. While the PHILOS plate is widely used for open reduction and internal fixation, minimally invasive techniques like tangari Prakash trauma system (TPTS) by Minimally Invasive Reduction and Osteosynthesis System (MIROS) offer a less invasive alternative. This study aimed to compare the functional outcomes and complication rates between TPTS by MIROS vs PHILOS plate fixation. Methods: A prospective, comparative study was conducted in the Department of Orthopedics at MVASMC Mirzapur, from January to June 2025. Sixty patients with Neer 2- or 3-part displaced proximal humerus fractures were randomized into two groups: Group A (n=30) treated with TPTS/MIROS and Group B (n=30) with PHILOS plate fixation. Patients were followed up at 3 and 6 months post-operatively. Functional outcome was assessed using the Constant-Murley Shoulder Score. Operative parameters and complications were also analyzed. Results: Both groups showed significant improvement in shoulder function over time. At 6 months, the mean Constant score was 77.3 ± 8.2 in Group A and 74.1 ± 9.5 in Group B (p=0.14). Group A had significantly shorter operative time (46.3 ± 6.9 min vs 77.5 ± 9.8 min, p<0.001), lower intraoperative blood loss (57.6 ± 11.4 ml vs 131.2 ± 18.6 ml, p<0.001), and shorter hospital stay (4.3 ± 1.2 days vs 6.6 ± 1.5 days, p=0.002). Complication rates were lower in Group A (10%) compared to Group B (20%), though the difference was not statistically significant. Conclusion: TPTS by MIROS provides functional outcomes comparable to PHILOS plate fixation while offering advantages of shorter operative time, reduced blood loss, fewer complications, and shorter hospital stay. It is a viable, cost-effective, and minimally invasive alternative, particularly suitable for elderly patients and resource-limited healthcare settings.