Outcome of Geriatric Proximal Humeral Fractures: a Comparison Between Reverse Shoulder Arthroplasty Versus Open Reduction and Internal Fixation

Overview

Journal OTA Int

Date 2022 Aug 11

PMID 35949265

Authors

Nadine Ott

Carolin Muller

Andreas Jacobs

Christian Paul

Kilian Wegmann

Lars Peter Muller

Koroush Kabir

Affiliations

Soon will be listed here.

Abstract

Objectives: In view of the increased attention to reverse shoulder arthroplasty (rTSA) as a treatment for complex proximal humeral fractures in the elderly, the present study analyzes in-hospital complications and the postoperative management of rTSA versus open reduction and internal fixation (ORIF).

Methods: We retrospectively reviewed patients hospitalized from 2016 to 2018 for proximal humeral fractures (ICD-9 codes: S42.21), III- and IV-part, who underwent an ORIF with locking plates, rTSA or nonoperative treatment. In-hospital complications and postoperative management in both groups were included in the analysis.

Results: We included n 190 patients (ORIF 90, rTSA 71, nonoperative 29), more likely to be female (82.1% vs 17.9%; .01) with an average age of 82years (min. 72, max. 99; SD 6.4). The ORIF and the rTSA groups showed comparable complication rates (15.6% vs 15%, .87) but with a significantly shorter hospital stay (8.6 vs 11.5days; .01) and shorter duration of surgery (72.9 vs 87.2 minutes; .01) in the ORIF group. Significantly more patients after ORIF achieved an independent life postoperatively (53.3% vs 40.8%; .013).

Conclusions: In this retrospective analysis, ORIF is related to a shorter duration of surgery, a shorter hospital stay and a higher likelihood of independence. Despite the popularity of the rTSA, ORIF remains a reliable treatment option for proximal humeral fractures in the elderly.Level of evidence: III.

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