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Displaced proximal humeral fractures: operative versus non-operative treatment—a 2-year extension of a randomized controlled trial

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

Surgical treatment for displaced proximal humeral fractures is widely used. However, there are very few randomized controlled studies comparing surgical treatment to conservative treatment, and the evidence is debated. The aim of this study was to describe patients with displaced proximal humeral fractures in a 2-years extension of a randomized controlled trial, their functional outcome and quality of life.

Materials and methods

Patients from a single-center randomized controlled study of fifty patients aged 60 or above with displaced proximal humeral fracture (AO/OTA group B2 or C2) were randomized to surgical or conservative treatment. Surgery was performed with an angular stable implant. The main outcome was Constant score at 2-year follow-up. Secondary outcomes were an ASES self-assessment form, the 15D quality of life assessment and radiographs at 2 years.

Results

A marked improvement of shoulder function and health-related quality of life for both surgically and conservatively treated patients occurs between 6 and 12 months. Almost no change was observed between 1 and 2 year. There were no significant differences between the two treatments at 2-year follow-up.

Conclusions

In this randomized controlled trial, surgical treatment proved no better results than conservative treatment for patients with displaced proximal humeral fracture at 2-year follow-up.

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Acknowledgments

The authors thanks statistician Lien My Diep, Oslo University Hospital Research Center for statistical advices. We also thank radiologist Judith Blücher and consultant orthopaedic surgeon Øyvind Paulsrud at Oslo Univiersity Hospital, for assisting scoring of the radiographs.

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Authors and Affiliations

  1. Orthopaedic Departement, Trauma, Division of Surgery and Clinical Neuroscience, Oslo University Hospital HF, Box 4950, 0424, Nydalen, Oslo, Norway

    Tore Fjalestad

  2. Department of Physical Therapy, Division of Medicine, Oslo University Hospital HF, Box 4950, 0424, Nydalen, Oslo, Norway

    Margrethe Øye Hole

Authors
  1. Tore Fjalestad
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  2. Margrethe Øye Hole
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Correspondence to Tore Fjalestad.

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Fjalestad, T., Hole, M.Ø. Displaced proximal humeral fractures: operative versus non-operative treatment—a 2-year extension of a randomized controlled trial. Eur J Orthop Surg Traumatol 24, 1067–1073 (2014). https://doi.org/10.1007/s00590-013-1403-y

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  • DOI: https://doi.org/10.1007/s00590-013-1403-y

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