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Functional and quality of life outcome after non-operatively managed proximal humeral fractures
Ronnart N Kruithof1, Henk A Formijne Jonkers1, Denise J C van der Ven1
1Department of Surgery, Meander Medical Center Amersfoort, P.O.-box 1502, 3800 BM, Amersfoort, The Netherlands.
Background:
Fractures of the proximal humerus are common and most often treated non-operatively. However, long-term follow-up studies focusing on functional results and quality of life in patients after this type of fracture are scarce. The primary aim of this study is to report the long-term functional and quality of life outcome in patients with a proximal humeral fracture.
Materials And Methods:
A retrospective analysis of all consecutive patients undergoing non-operative treatment for a proximal humeral fracture in a level 2 trauma centre between January 2000 and December 2013 was performed. A database consisting of all relevant demographic, patient and fracture characteristics was created. Subsequently, a questionnaire containing the DASH (Disabilities of the Arm, Shoulder and Hand) score, EuroQol-5D (EQ-5D), VAS (visual analogue scale) score, and subjective questions was sent to all patients.
Results:
A total of 410 patients (65 male, 345 female) were included for analyses. Average follow-up was 90 ± 48 months. DASH-scores <15 were considered as good. A median DASH-score of 6.67 [0.83-22.50] was found. A significant lower DASH-score was seen in patients under the age of 65 compared to older patients (p < 0.001). In comparison to an age-matched general Dutch population, Health related Quality of Life (HrQoL) on the EQ-us was not significantly worse in our study population (difference 0.02). Strong (negative) correlation was found between DASH-score and VAS-score, and DASH-score and HrQoL, respectively ρ = -0.534 and ρ = -0.787.
Conclusion:
Long-term functional and quality of life outcomes are good in most patients after proximal humeral fractures, but negatively correlated to each other.
Level Of Evidence:
Level III.
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