Conservative Slings Can Replace Surgery for Shoulder Fractures
By HospiMedica International staff writers Posted on 20 Aug 2019 |
A new study suggests that performing surgery on the majority of displaced proximal humerus fractures (PHFs) in older adults may not be beneficial.
Researchers at Tampere University Hospital (Finland), University Hospital (Stockholm, Sweden), Aarhus University Hospital (Denmark), and other institutions conducted a study involving 88 patients aged 60 years or older (the majority female) who were treated with a displaced 2-part anatomical neck PHF in six hospitals in Finland, Estonia, Sweden, and Denmark; all patients underwent rehabilitation under the supervision of a physiotherapist. The primary outcome measure was Disabilities of Arm, Shoulder, and Hand (DASH) score at two-year follow-up.
The study showed no differences between operative treatment and non-operative treatment, based on a patient-reported outcome measure (PROM) or quality of life (QOL) score. No statistically or clinically significant differences in PROMs were observed between the operative and non-operative treatment groups. The results were already valid one year after treatment. The study was published on July 18, 2019, in PLOS Medicine.
“The results are thought-provoking in that there is no difference between patients who underwent surgery and those who didn't. Those who underwent surgery don't have better shoulder function or less pain than those who didn't,” said lead author Professor Inger Mechlenburg, MD, of Aarhus University Hospital. “As there is no difference in the patients' ability to carry out daily chores, their level of pain or quality of life with or without the displaced shoulder fracture surgery, then treatment with only a sling should be preferred, as the patients thereby avoid surgery-related pain and complications.”
PHFs are among the most common fractures in the older adult population. The risk for having a PHF increases with age, especially after the age of 60 years, and most are associated with a low-energy fall. According to published literature, minimally displaced or 2-part fractures constitute between 77% and 84% of all fractures, for which non-operative treatment can be considered. Fracture comminution and displacement, especially in 3- and 4-part fractures, on the other hand, are considered to be potential indications for operative treatment.
Related Links:
Tampere University Hospital
University Hospital
Aarhus University Hospital
Researchers at Tampere University Hospital (Finland), University Hospital (Stockholm, Sweden), Aarhus University Hospital (Denmark), and other institutions conducted a study involving 88 patients aged 60 years or older (the majority female) who were treated with a displaced 2-part anatomical neck PHF in six hospitals in Finland, Estonia, Sweden, and Denmark; all patients underwent rehabilitation under the supervision of a physiotherapist. The primary outcome measure was Disabilities of Arm, Shoulder, and Hand (DASH) score at two-year follow-up.
The study showed no differences between operative treatment and non-operative treatment, based on a patient-reported outcome measure (PROM) or quality of life (QOL) score. No statistically or clinically significant differences in PROMs were observed between the operative and non-operative treatment groups. The results were already valid one year after treatment. The study was published on July 18, 2019, in PLOS Medicine.
“The results are thought-provoking in that there is no difference between patients who underwent surgery and those who didn't. Those who underwent surgery don't have better shoulder function or less pain than those who didn't,” said lead author Professor Inger Mechlenburg, MD, of Aarhus University Hospital. “As there is no difference in the patients' ability to carry out daily chores, their level of pain or quality of life with or without the displaced shoulder fracture surgery, then treatment with only a sling should be preferred, as the patients thereby avoid surgery-related pain and complications.”
PHFs are among the most common fractures in the older adult population. The risk for having a PHF increases with age, especially after the age of 60 years, and most are associated with a low-energy fall. According to published literature, minimally displaced or 2-part fractures constitute between 77% and 84% of all fractures, for which non-operative treatment can be considered. Fracture comminution and displacement, especially in 3- and 4-part fractures, on the other hand, are considered to be potential indications for operative treatment.
Related Links:
Tampere University Hospital
University Hospital
Aarhus University Hospital
Latest Surgical Techniques News
- Miniaturized Implantable Multi-Sensors Device to Monitor Vessels Health
- Tiny Robots Made Out Of Carbon Could Conduct Colonoscopy, Pelvic Exam or Blood Test
- Miniaturized Ultrasonic Scalpel Enables Faster and Safer Robotic-Assisted Surgery
- AI Assisted Reading Tool for Small Bowel Video Capsule Endoscopy Detects More Lesions
- First-Ever Contact Force Pulsed Field Ablation System to Transform Treatment of Ventricular Arrhythmias
- Caterpillar Robot with Built-In Steering System Crawls Easily Through Loops and Bends
- Tiny Wraparound Electronic Implants to Revolutionize Treatment of Spinal Cord Injuries
- Small, Implantable Cardiac Pump to Help Children Awaiting Heart Transplant
- Gastrointestinal Imaging Capsule a Game-Changer in Esophagus Surveillance and Treatment
- World’s Smallest Laser Probe for Brain Procedures Facilitates Ablation of Full Range of Targets
- Artificial Intelligence Broadens Diagnostic Abilities of Conventional Coronary Angiography
- AI-Powered Surgical Visualization Tool Supports Surgeons' Visual Recognition in Real Time
- Cutting-Edge Robotic Bronchial Endoscopic System Provides Prompt Intervention during Emergencies
- Handheld Device for Fluorescence-Guided Surgery a Game Changer for Removal of High-Grade Glioma Brain Tumors
- Porous Gel Sponge Facilitates Rapid Hemostasis and Wound Healing
- Novel Rigid Endoscope System Enables Deep Tissue Imaging During Surgery