Comparison of Conservative and Arthroplasty Treatment for 3 or 4 Part Proximal Humerus Fractures in the Elderly

Year 2024, Volume: 6 Issue: 2, 219 - 223, 16.05.2024

Mehmet Akdemir , Ahmet Çağdaş Biçen , Ahmet Cemil Turan , Ahmet Ekin , Ali İhsan Kılıç , Meric Unal

https://doi.org/10.37990/medr.1418007

Abstract

Aim: Proximal humerus fractures are common injuries in the elderly population. This study hypothesizes that arthroplasty is not superior to conservative treatment in the management of multi-part proximal humerus fractures in elderly patients.
Material and Method: Patients aged 65 and above with 3–4-part proximal humerus fractures, treated either conservatively or with arthroplasty, were included in the study. The minimum follow-up period was set at 12 months. Functional evaluations of the patients were performed using the Quick Disabilities of Arm, Shoulder and Hand (Q-DASH) scoring system. Statistical analysis comparing the two groups was conducted using the SPSS software. The mean values of numerical data were analyzed using the Mann-Whitney U test, while categorical data were compared using the Chi-square test. A significant level of 0.05 was considered.
Results: A total of 67 patients who received adequate clinical follow-up were included in the study (50 conservative 17 arthroplasty). The average age of the patients was 76.12 years, with 9 male and 58 female patients. The average follow-up period was 22.61 months (range: 12-82). There were no statistically significant differences in age, gender, side, follow-up period, and fracture type distribution between the two groups. However, a significant difference in Q-DASH scores was observed (p<0.05).
Conclusion: In the treatment of proximal humerus fractures, even when they are multi-part fractures, conservative treatment should may be the first choice. We think that the early results of conservative treatment are better than arthroplasty.

Keywords

Proximal humerus fracture, conservative treatment, shoulder arthroplasty

Ethical Statement

Suleyman Demirel University Faculty of Medicine clinical research ethics committee approval was received. Number: 72867572.050.01.04-37133

Supporting Institution

none

Thanks

none

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