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Study shows increase in arthroplasty as treatment of proximal humerus fragility fractures
While nonoperative management of proximal humerus fragility fractures remains the most common treatment among elderly patients, there has been an increase in shoulder arthroplasty for this population, according to results.
Researchers obtained associated patient demographics, hospital data, and treatment and revision status for 259,506 proximal humerus fractures that occurred in a Medicare population identified in the PearlDiver Database.
Overall, results showed 67% of patients were treated nonoperatively vs. 33% who were treated operatively. Of the operatively treated patients, 19.3% were treated with open reduction and internal fixation (ORIF), 11.2% with hemiarthroplasty and 2.4% with total shoulder arthroplasty (TSA). Across all age groups, researchers found nonoperative management was the most commonly used treatment, with nonoperative management increasing from 49% in patients aged 65 years to 69 years to 82% in patients older than 85 years of age.
Alan L. Zhang
When it came to surgical treatment, ORIF was the most common surgical treatment in all age groups, according to results. However, the rate of ORIF decreased with age (62% of patients aged 65 years to 69 years vs. 54% of patients aged 80 years to 84 years).
A significantly higher frequency of proximal humerus fractures were found among women. According to results, men were more likely than women to be treated nonoperatively (70% vs. 66%) and with ORIF (66% vs. 57%), while women compared with men were more likely to have hemiarthroplasty (35% vs. 28%) and TSA (8% vs. 6%).
Researchers noted a 96.7% overall implant survival rate without revision for all surgical options, according to patient data collected during 2 years. Results showed a 1-year survival rate of 96.5% and a 2-year survival rate of 95.3% for ORIF without revision ORIF or conversion to another procedure. – by Casey Tingle
Disclosures: Zhang reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.