Shoulder dominance has no effect on function, quality of life after proximal humerus fracture
Recently published data indicated there was no significant difference with regard to shoulder dominance in the functional outcome and quality of life perception observed in proximal humeral fractures.
Researchers retrospectively studied 179 patients with proximal humeral fractures (PHFs). Fractures were divided into two groups based on whether they occurred in the dominant or nondominant arm. Seventy-six fractures were treated surgically, and 103 were treated conservatively with 3-week immobilization with a sling and an assisted progressive rehabilitation program.
Each group was prospectively observed during a 2-year period. At the end of the 2-year follow-up, all patients underwent functional assessments using the Constant score, and quality life was assessed using SF-36. In addition, patients were asked if they were independent for activities of daily living (ADLs) in order to assess mortality and level of autonomy.
Results showed the mean Constant score at the 2-year follow-up was 65.5 for the dominant group and 66.8 for the nondominant group, with no significant differences noted between the two groups for the total Constant score or any of the Constant score items, according to the researchers.
At the 2-year follow-up, the mean SF-36 physical component summary score was 40.8 for the dominant group and 41.9 for the nondominant group. The mean SF-36 mental component scores for the dominant group and the nondominant group were 43.5 and 42.7, respectively.
Mean mortality rate at follow-up for the dominant group was 3.9% compared with 3.7 in the nondominant group; again, no significant differences were observed between groups.
Eighty percent of patients in the dominant group were independent for ADLs compared with 84% of patients in the nondominant group.
The researchers concluded dominance of the affected shoulder should not be used to make treatment decisions for patients with PFHs. ‒ by Monica Jaramillo
Disclosures: Torrens reports he is a paid consultant and paid presenter or speaker for DePuy, A Johnson & Johnson Company. Please see the full study for a list of all other authors’ relevant financial disclosures.