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Journals / Medical Records / 2026 / Cilt: 6 Sayı: 2

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

Mehmet Akdemir(özel izmir ekol hastanesi)0000-0001-9638-4907
Ahmet Çağdaş Biçen(Klinikum Bremen Mitte, Klinik für Unfallchirurgie und Traumatologie)0000-0002-0711-9376
Ahmet Cemil Turan(özel klinik)0000-0002-7149-3055
Ahmet Ekin(İZMİR EKONOMİ ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-9302-9475
Ali İhsan Kılıç(İZMİR BAKIRÇAY ÜNİVERSİTESİ, TIP FAKÜLTESİ)0000-0001-7491-6044
Meric Unal(özel meddem hastanesi)0000-0001-9576-5994
Pages
219–223
Publication Date
2024-05-16
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

We think that the early results of conservative treatment are better than arthroplasty.

📌 3 Key Takeaways

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Objective & Hypothesis:Aim: Proximal humerus fractures are common injuries in the elderly population.
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Key Findings & Data: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.
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Conclusion & Impact:We think that the early results of conservative treatment are better than arthroplasty.
🔬Design:Klinik Araştırma
📍Scope:Comprehensive Sample
⚙️Variables:Proximal humerus fracture · conservative treatment · shoulder arthroplasty

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.

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Cite This Article

Akdemir, M., Biçen, A. Ç., Turan, A. C., Ekin, A., Kılıç, A. İ., Unal, M. (2024). Comparison of Conservative and Arthroplasty Treatment for 3 or 4 Part Proximal Humerus Fractures in the Elderly. Medical Records, Cilt: 6 Sayı: 2, 219–223. https://doi.org/10.37990/medr.1418007

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References (20)

  1. Handoll HH, Ollivere BJ. Interventions for treating proximal humeral fractures in adults. Cochrane Database Syst Rev. 2010;12:CD000434.
  2. Kancherla VK, Singh A, Anakwenze OA. Management of acute proximal humeral fractures. J Am Acad Orthop Surg. 2017;25:42-52.
  3. Rangan A, Handoll H, Brealey S, et al.; PROFHER trial collaborators. Surgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial. JAMA. 2015;313:1037-47.
  4. Tamimi I, Montesa G, Collado F, et al. Displaced proximal humeral fractures: when is surgery necessary?. Injury. 2015;46:1921-9.
  5. O'Donnell JA, Gage MJ. Proximal humerus geriatric fracture care: fix, replace, or nonoperative treatment?. J Orthop Trauma. 2021;35:S6-10.
  6. Gigis I, Nenopoulos A, Giannekas D, et al. Reverse shoulder arthroplasty for the treatment of 3 and 4- part fractures of the humeral head in the elderly. Open Orthop J. 2017;11:108-18.
  7. Tepass A, Blumenstock G, Weise K, et al. Current strategies for the treatment of proximal humeral fractures: an analysis of a survey carried out at 348 hospitals in Germany, Austria, and Switzerland. J Shoulder Elbow Surg. 2013;22:e8-14.
  8. Resch H, Povacz P, Fröhlich R, Wambacher M. Percutaneous fixation of three- and four-part fractures of the proximal humerus. J Bone Joint Surg Br. 1997;79:295-300.
  9. Krappinger D, Bizzotto N, Riedmann S, et al. Predicting failure after surgical fixation of proximal humerus fractures. Injury. 2011;42:1283-8.
  10. Large TM, Adams MR, Loeffler BJ, Gardner MJ. Posttraumatic avascular necrosis after proximal femur, proximal humerus, talar neck, and scaphoid fractures. J Am Acad Orthop Surg. 2019;27:794-805.
  11. Jawa A, Burnikel D. Treatment of proximal humeral fractures: a critical analysis review. JBJS Rev. 2016;4:e2.
  12. Antonios T, Bakti N, Phadkhe A, et al. Outcomes following arthroplasty for proximal humeral fractures. J Clin Orthop Trauma. 2020;11:S31-6.
  13. Schairer WW, Nwachukwu BU, Lyman S, et al. Reverse shoulder arthroplasty versus hemiarthroplasty for treatment of proximal humerus fractures. J Shoulder Elbow Surg. 2015;24:1560-6.
  14. Cheung E, Willis M, Walker M, et al. Complications in reverse total shoulder arthroplasty. J Am Acad Orthop Surg. 2011;19:439-49.
  15. Roberson TA, Granade CM, Hunt Q, et al. Nonoperative management versus reverse shoulder arthroplasty for treatment of 3- and 4-part proximal humeral fractures in older adults. J Shoulder Elbow Surg. 2017;26:1017-22.
  16. Erpala F, Tahta M, Öztürk T, Zengin Ç. Comparison of treatment options of three- and four-part humerus proximal fractures in patients over 50 years of age. Cureus. 2021;13:e17516.
  17. Xie L, Ding F, Zhao Z, et al. Operative versus non-operative treatment in complex proximal humeral fractures: a meta-analysis of randomized controlled trials. Springerplus. 2015;4:728.
  18. Song JQ, Deng XF, Wang YM, et al. Operative vs. nonoperative treatment for comminuted proximal humeral fractures in elderly patients: a current meta-analysis. Acta Orthop Traumatol Turc. 2015;49:345-53.
  19. Osterhoff G, Ossendorf C, Wanner GA, et al. The calcar screw in angular stable plate fixation of proximal humeral fractures--a case study. J Orthop Surg Res. 2011;6:50.
  20. Lopiz Y, Alcobía-Díaz B, Galán-Olleros M, et al. Reverse shoulder arthroplasty versus nonoperative treatment for 3- or 4-part proximal humeral fractures in elderly patients: a prospective randomized controlled trial. J Shoulder Elbow Surg. 2019;28:2259-71.