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Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment?
BACKGROUND: Over 75 % of patients presenting with a proximal humerus fracture are 70 years or older. Very little is known about the outcome after operative treatment of these fractures in very old patients. This study was performed to gain more insight in safety and functional outcome of surgical tr...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033798/ https://www.ncbi.nlm.nih.gov/pubmed/24233865 http://dx.doi.org/10.1007/s10195-013-0273-8 |
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author | de Kruijf, Marjolein Vroemen, J. P. A. M. de Leur, K. van der Voort, E. A. M. Vos, D. I. Van der Laan, L. |
author_facet | de Kruijf, Marjolein Vroemen, J. P. A. M. de Leur, K. van der Voort, E. A. M. Vos, D. I. Van der Laan, L. |
author_sort | de Kruijf, Marjolein |
collection | PubMed |
description | BACKGROUND: Over 75 % of patients presenting with a proximal humerus fracture are 70 years or older. Very little is known about the outcome after operative treatment of these fractures in very old patients. This study was performed to gain more insight in safety and functional outcome of surgical treatment of proximal humerus fractures in the elderly. MATERIALS AND METHODS: In this observational study, we analyzed all operatively treated patients, aged 75 or older, with a proximal humerus fracture between January 2003 and December 2008 in our center. Patient selection was on clinical grounds, based on physical, mental, and social criteria. Complications were evaluated. We used the DASH Questionnaire to investigate functional outcome, pain, and ADL limitations. RESULTS: Sixty-four patients were treated surgically for a displaced proximal fracture of the humerus: 15 two-part, 32 three-part, and 17 four-part fractures. Mean DASH scores were 37.5, 36.9, and 48.6, respectively. Regarding the operative methods, overall good results were obtained with the modern locked plate osteosynthesis (mean DASH 34.4). Prosthetic treatment, mostly used in highly comminuted fractures, often resulted in poor function (mean DASH 72.9). Persistent pain and ADL limitations were more present in more comminuted fractures (64 and 50 % in patients with 4-part fractures vs. 14 % in 2-part fractures). There were no postoperative deaths within 3 months of surgery, and fracture-related and non-fracture-related complication rates were low (non-union 3 %; 1 myocardial infarction). CONCLUSION: This study shows that it is safe and justifiable to consider surgical treatment of a severely dislocated proximal humerus fracture in selected patients aged 75 and older. LEVEL OF EVIDENCE: According to OCEBM Working Group, Level IV. |
format | Online Article Text |
id | pubmed-4033798 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-40337982014-05-29 Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? de Kruijf, Marjolein Vroemen, J. P. A. M. de Leur, K. van der Voort, E. A. M. Vos, D. I. Van der Laan, L. J Orthop Traumatol Original Article BACKGROUND: Over 75 % of patients presenting with a proximal humerus fracture are 70 years or older. Very little is known about the outcome after operative treatment of these fractures in very old patients. This study was performed to gain more insight in safety and functional outcome of surgical treatment of proximal humerus fractures in the elderly. MATERIALS AND METHODS: In this observational study, we analyzed all operatively treated patients, aged 75 or older, with a proximal humerus fracture between January 2003 and December 2008 in our center. Patient selection was on clinical grounds, based on physical, mental, and social criteria. Complications were evaluated. We used the DASH Questionnaire to investigate functional outcome, pain, and ADL limitations. RESULTS: Sixty-four patients were treated surgically for a displaced proximal fracture of the humerus: 15 two-part, 32 three-part, and 17 four-part fractures. Mean DASH scores were 37.5, 36.9, and 48.6, respectively. Regarding the operative methods, overall good results were obtained with the modern locked plate osteosynthesis (mean DASH 34.4). Prosthetic treatment, mostly used in highly comminuted fractures, often resulted in poor function (mean DASH 72.9). Persistent pain and ADL limitations were more present in more comminuted fractures (64 and 50 % in patients with 4-part fractures vs. 14 % in 2-part fractures). There were no postoperative deaths within 3 months of surgery, and fracture-related and non-fracture-related complication rates were low (non-union 3 %; 1 myocardial infarction). CONCLUSION: This study shows that it is safe and justifiable to consider surgical treatment of a severely dislocated proximal humerus fracture in selected patients aged 75 and older. LEVEL OF EVIDENCE: According to OCEBM Working Group, Level IV. Springer International Publishing 2013-11-15 2014-06 /pmc/articles/PMC4033798/ /pubmed/24233865 http://dx.doi.org/10.1007/s10195-013-0273-8 Text en © The Author(s) 2013 https://creativecommons.org/licenses/by/2.0/ Open AccessThis article is distributed under the terms of the Creative Commons Attribution License which permits any use, distribution, and reproduction in any medium, provided the original author(s) and the source are credited. |
spellingShingle | Original Article de Kruijf, Marjolein Vroemen, J. P. A. M. de Leur, K. van der Voort, E. A. M. Vos, D. I. Van der Laan, L. Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
title | Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
title_full | Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
title_fullStr | Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
title_full_unstemmed | Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
title_short | Proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
title_sort | proximal fractures of the humerus in patients older than 75 years of age: should we consider operative treatment? |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4033798/ https://www.ncbi.nlm.nih.gov/pubmed/24233865 http://dx.doi.org/10.1007/s10195-013-0273-8 |
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