Locking plate versus nonsurgical treatment for proximal humeral fractures: better midterm outcome with nonsurgical treatment

Sanders, R. R.; Thissen, Luc G.; Teepen, Jop C.; Kampen, A. van; Jaarsma, Ruurd L.

doi:10.1016/j.jse.2011.01.025

Cited by 64 publications

(36 citation statements)

References 30 publications

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“…This finding is in accordance with several previous studies [12,13,29]. The average EQ-5D score found in this study is considerably lower than the EQ-5D reference value for the general Dutch population aged over 65 [32], which supports the claim that a proximal humeral fracture in elderly patients/patients over 65 is related to a diminished quality of life.…”

Section: Discussionsupporting

confidence: 93%

“…Nevertheless, operative treatment is associated with a higher risk of complications related to the implant or the surgical procedure [11]. To date, research has not been able to identify evident and reliable differences in outcome between operative and nonoperative treatment [12][13][14]. This was supported by the latest Cochrane review [15].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Traumatic diaphragmatic rupture in pediatric age: review of the literature

Marzona

Parri

Nocerino

et al. 2016

Eur J Trauma Emerg Surg

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Purpose Despite a rising incidence in proximal humeral fractures, there is still no evidence for the best treatment option, especially for elderly patients. The aim of this retrospective cohort study was to evaluate health-related quality of life (HRQoL), functional outcome, pain and social participation in elderly patients, after operative and nonoperative treatment of displaced 3-and 4-part proximal humeral fractures. Methods 150 patients aged ≥ 65, treated for a displaced 3-or 4-part proximal humeral fracture between 2004 and 2014, were invited to participate. Eventually 91 patients (61%) participated, of which 32 non-operatively treated patients were matched to 32 of the 59 operatively treated patients by propensity score matching. The EQ-5D, DASH, VAS for pain and WHODAS 2.0 Participation in Society domain were administered. Complications and reinterventions were registered. Results No significant difference was found between the two treatment groups in HRQoL (p = 0.43), function (p = 0.78) and pain (p = 0.19). A trend toward better social participation in the operative group (p = 0.09) was found. More complications and reinterventions occurred in the operative group than the nonoperative group, with 9 versus 5 complications (p = 0.37) and 8 versus 2 reinterventions (p = 0.08). Conclusions In this study, we found no evidence of a difference in HRQoL, functional outcome or pain 1-10 years after operative or nonoperative treatment in patients of 65 and older with a displaced 3-or 4-part humeral fracture. Operatively treated patients showed a trend toward better social participation but also higher reintervention rates.

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Section: Discussionsupporting

confidence: 93%

Section: Introductionmentioning

confidence: 99%

Traumatic diaphragmatic rupture in pediatric age: review of the literature

Marzona

Parri

Nocerino

et al. 2016

Eur J Trauma Emerg Surg

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“…There have been many studies that have analyzed patient quality of life following a specified treatment option for a PHF and distal radius fracture [22][23][24][25][26]. Olerud et al [25] described the increase in functional outcome and quality of life following surgical intervention compared to non-operative treatment for PHF.…”

Section: Discussionmentioning

confidence: 99%

“…Our results showed that all ages have decreased independence following these upper extremity fractures and this loss of independence can have a greater impact on older patients. Furthermore, regardless of treatment option, upper extremity fracture patients have problems with mobility, personal care, and are unable to perform their usual activities [26]. More research needs to be done regarding optimizing who we select for surgical versus non-surgical management and how treatment selection impacts not only patient satisfaction and function but also socio-economic impact.…”

Section: Discussionmentioning

confidence: 99%

Economic and social impact of upper extremity fragility fractures in elderly patients

et al. 2015

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“…Bemerkenswert ist aber die im Vergleich zur konservativen Therapie deutlich hö-here Komplikationsrate im Philos®-Arm, bei dem in 30% operative Revisionen notwendig wurden. Sanders et al beschreiben 2011 die Ergebnisse aus einer Matched-pair-Analyse, in der sie 36 Humeruskopffrakturen verglichen [13]. Diese wurden entweder konservativ oder mit einer winkelstabilen Platte versorgt.…”

Section: Hauptkomplikation Ist Die Varusdislozierte Pseudarthroseunclassified

Frakturen des Humeruskopfes

Jaeger

Izadpanah

Maier

et al. 2012

Chirurg

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Fractures of the proximal humerus are commonly seen especially in the elderly population. High-energy trauma in young people can be distinguished from low-energy trauma in the elderly resulting from falls of a low height which are typically characterized by osteoporosis. A precise analysis of fractures is essential for a good understanding of the fracture and an individual therapy for which the LEGO-Codman classification provided by Hertel is recommended. Nonsurgical therapy is commonly performed and widely accepted not only for simple fractures. For osteosynthesis angular stable implants became the gold standard but are frequently associated with a high rate of complications some of which can be lowered by an improved surgical technique. Even today varus dislocated fractures are challenging, especially in combination with destruction of the medial column. In those cases where stable osteosynthesis can no longer be achieved arthroplasty is indicated. The clinical results of anatomic fracture arthroplasty are strongly related with correct ingrowth of the tuberosities. Reverse fracture arthroplasty may be considered but indications should be interpreted with caution and preferably used in patients older than 75 years.

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Locking plate versus nonsurgical treatment for proximal humeral fractures: better midterm outcome with nonsurgical treatment

Cited by 64 publications

References 30 publications

Traumatic diaphragmatic rupture in pediatric age: review of the literature

Traumatic diaphragmatic rupture in pediatric age: review of the literature

Economic and social impact of upper extremity fragility fractures in elderly patients

Frakturen des Humeruskopfes

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