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Changing trends in the management of proximal humerus fractures in New York State
Michael J Sayegh1, Ryan A Nixon1, Dean C Perfetti1
1Department of Orthopaedic Surgery, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, NY, USA.
Purpose:
Reverse shoulder arthroplasty (RSA) as an alternative to hemiarthroplasty (HA) as treatment for proximal humerus fractures has prompted a re-evaluation of utilization trends.
Methods:
Operative treatment for proximal humeral fractures were analyzed using a New York State database.
Results:
After introduction as an ICD-9 code, RSA increased to 39.3% (m = +5.2%/year, r = 0.984). When stratifying by age ≥65, HA decreased to 7.7% (m = -2.8%/year, r = 0.962) while RSA increased to 50.6% (m = +6.4%/year, r = 0.985).
Conclusion:
RSA overtook HA as the arthroplasty procedure of choice for proximal humerus fractures. In patients ≥65, RSA passed ORIF as the most prevalent procedure in 2017.
Level Of Evidence:
III, Descriptive Epidemiology Study, Large Database Analysis.
