Use of an evidence-based treatment algorithm in patients with proximal humerus fractures proved to be a helpful tool for decision-making and led to “satisfying” overall results with low complication and revision rates, according to published findings.
Researchers recorded quality of life and the level of autonomy before injury in 192 patients with isolated proximal humerus fractures, as well as classified the fractures and measured local bone quality. Researchers treated 83% of patients according to an evidence-based treatment algorithm that prioritizes patients’ demands and biology and includes all treatment options from conservative to reverse total shoulder arthroplasty. Radiographs, Constant score, subjective shoulder value and EuroQol-5D were reviewed at 3-month and 1-year follow-up, and researchers analyzed the rate of unplanned surgery.
Results showed conservative treatment, open reduction and internal fixation, and reverse total shoulder arthroplasty or hemiarthroplasty was used in 132 patients, 36 patients and 24 patients, respectively. Researchers found patients had a mean EQ-5D of 0.88 points before trauma and 0.9 points 1 year after treatment, as well as an overall mean relative Constant score of 95% and mean subjective shoulder value of 84% after 1 year. Overall, 21 patients underwent unplanned surgery.
“In our collective, apart from patients treated with [hemiarthroplasty] HA, the overall functional outcomes after 1 year was successful, especially if algorithm pathways were followed correctly,” the authors wrote. – by Casey Tingle
Disclosures: The authors report no relevant financial disclosures.