Study supports nonoperative treatment of pediatric, displaced proximal humerus fractures
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Similar to results from an operative approach, nonoperative treatment of displaced proximal humerus fractures in adolescents provided “excellent functional outcomes” at 3 and 6 months after injury, according to a speaker.
“[Proximal humerus fractures] are largely treated nonoperatively because of the significant remodeling potential and the remaining growth that the proximal humerus has,” Pooya Hosseinzadeh, MD, said in his presentation at the Pediatric Orthopaedic Society of North America Annual Meeting.
Hosseinzadeh and colleagues analyzed 44 patients (average age of 12.7 years) who sustained displaced proximal humerus fractures and underwent either operative or nonoperative treatment, 23 of which were available at 3-month follow-up and eight were available at 6-month follow-up.
Outcome measures included the patient-reported outcome measurement instrument (PROMIS) upper extremity and pain scores, as well as quick DASH (qDASH) and shoulder pain and disability index (SPADI) scores.
“We found similar patient-reported outcome scores in adolescents with displaced proximal humerus fractures that were treated operatively and nonoperatively,” Hosseinzadeh said.
At 3-month follow-up, PROMIS pain scores were 38.2 in the nonoperative group vs. 37.6 in the operative group, PROMIS upper extremity scores were 52.8 in the nonoperative group vs. 51 in the operative group, qDASH scores were 5.6 in the nonoperative group vs. 6.4 in the operative group and SPADI scores were 3.7 in the nonoperative group vs. 1 in the operative group.
Hosseinzadeh noted patient follow-up was a limitation of the study, as it has been in other trauma-related studies; however, the results provide support to the use of nonoperative treatment for pediatric patients with proximal humerus fractures, he concluded.
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Hosseinzadeh P, et al. Paper 15. Presented at: Pediatric Orthopaedic Society of North America Annual Meeting; May 12-15, 2021; Dallas (hybrid meeting).
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