Despite better implant designs, there are still chances of complications such as avascular necrosis of humeral head, subacromial impingement, varus The main approach of uni-displaced, stable or minimally displaced proximal humeral fractures is conservative and more than 80% of these injuries 7,8 heal without any surgical intervention. However in nearly 20% of the cases, these fractures are moderate to severely displaced and treatment regime for such kind of fractures is not fully 8 defined. Surgical fixation is indicated for displaced and unstable fractures since early reduction and fixation leads to faster rehabilitation and improved 9 functional status. However, certain factors which affect the outcome in these fractures are increasing age, co morbidities such as diabetes and hypertension, weak osteoporotic bones, displaced 10,11 and comminuted fracture fragments. To overcome these problems and to achieve treatment goals improved surgical techniques, fixation methods and better implants have been 6,8 designed. Out of these, locking plates which are contoured anatomically according to the shape of proximal humerus known as Proximal Humeral Internal Locking System PHILOS (Synthes, Solothurn, Switzerland) has been developed by 12,13 AO/ASIF foundation. PHILOS provides rotational, angular and axial stability. It has better screw fixation in old osteoporotic bone with 13-15 minimum soft tissue stripping. INTRODUCTION Fractures of the proximal humerus (FPH) are the third most common fractures, after hip and Colles' 1 fractures in the elderly people. Proximal humeral fractures account for 5-6% of all fractures and the 1-3 incidence is higher among older age women. Nearly 85% of these fractures occur in people over the age of 50 years with the peak incidence in 60 to 4 90 years of age. These fractures are usually caused by low-energy trauma in osteoporotic elderly individuals or by high-energy trauma in young patients leading to more displacement of the fracture 5 fragments. The treatment goal is to achieve a 6 painless shoulder with normal range of motion. Methodology: This systematic case series was conducted at the Department of Trauma and Orthopedics, JPMC Karachi Pakistan from December 2017 to November 2019. A total of 81 patients of age 20 years and above of either sex presented with 3-part fracture, 4-part fracture or fracture-dislocation (according to the Neer classification system) with angulations of >45º or displacement of >1cm and fracture duration of less than two weeks were enrolled. Patients with pathological fractures secondary to tumors, infection and connective tissue disorders were excluded from the study. Passive elevation and rd rotation exercises were started on day 3 day of operation. Active range-of-movement exercises were started at week 6. Final outcome was th assessed on 24 week in terms of range of motion Conclusion: The functional outcome of PHILOS plate system in displaced proximal humerus fractures was found satisfactory. (Rawal Med J 202;45:633-636). Objective: To assess the functional outcome of proximal Humerus fractures after fixation with the PHILOS (Proximal Humerus Interlocking System) plating system in Sindh, Pakistan. Results: There were 25 (30%) patients with 3-part fracture, 41 (50%) with 4-part fracture and 15 (18%) patients had fracture dislocation. Right limb was involved in 55 (67%) patients and left limb was involved in 26 (32%) patients. Overall satisfactory outcome was found in 70 (86%) patients. Keywords: Fracture proximal Humerus, Functional outcome, PHILOS plate. 633 Functional outcomes of locking plate fixation in complex proximal humerus fractures Saeed Ahmed Shaikh, Muhammad Arif Arain, Muhammad Mansoor Rehman, Nadeem Ahmed, Muhammad Qasim Ali Samejo Department of Orthopedics, Jinnah Post Graduate Medical Center, Karachi, Pakistan Rawal Medical Journal: Vol. 45. No. 3, July-Sept. 2020 Original Article