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Better function, but 30% reoperation rate seen with plating humeral fractures in elderly patients
Olerud P. J Shoulder Elbow Surg. 2011; Mar 23. [Epub ahead of print]. doi:10.1016/j.se.2010.12.018.
A level 1 study shows superior function and health related quality of life at 2 years in elderly patients with displaced three-part proximal humeral fractures who underwent internal fixation rather than nonoperative treatment.
However, investigators note the advantages of fixation come “at the cost of additional surgery in 30% of the patients.”
Per Olerud, MD, and colleagues from Sweden performed a 2-year follow-up of 60 patients who had a mean age of 74 years and were randomized to receive either internal fixation with a locking plate or nonoperative treatment for a displaced three-part proximal humeral fracture.
A comparison of the groups at 2 years revealed that patients in the locked plate cohort had 9° greater mean flexion and 8° more mean abduction. In addition, the investigators discovered better Constant scores, lower DASH scores and superior EQ-5D index scores for patients in the locked plate group. According to the study abstract, 13% of plated patients needed a major reoperation due to a fracture complication and 17% required a minor reoperation.