5-Year Mortality After Complex Displaced Proximal Humerus Fractures in Elderly Patients: Conservative Versus Reverse...

Area of Science:

• Orthopedic Surgery
• Geriatric Medicine
• Public Health

Background:

• Elderly patients with proximal humerus fractures (PHFs) face increased mortality.
• Limited medium-term data exists comparing Reverse Total Shoulder Arthroplasty (RTSA) to non-surgical management for PHFs in this demographic.
• This study addresses the gap in understanding long-term survival following different treatment modalities for PHFs in the elderly.

Purpose of the Study:

• To compare medium-term mortality rates between elderly patients treated with RTSA and those receiving non-surgical management for PHFs.
• To investigate potential differences in survival outcomes based on treatment approach.
• To identify if specific patient subgroups exhibit varied mortality patterns.

Main Methods:

• Retrospective cohort study comparing two groups of elderly patients (75-95 years) with PHFs.
• Group 1: 79 patients treated non-surgically (2008-2010).
• Group 2: 81 patients treated with RTSA (2012-2017).
• Mortality rates were recorded at 1 month, 1 year, and 5 years post-injury.

Main Results:

• No significant difference in 1-month, 1-year, or 5-year mortality rates between RTSA and non-surgical groups (p > 0.05 for all).
• Five-year mortality was 33.3% for RTSA and 38.0% for non-surgical treatment.
• Subgroup analysis indicated that observed mild differences in mortality were primarily associated with male patients.

Conclusions:

• RTSA and non-surgical treatment yield comparable five-year mortality rates in elderly patients with PHFs.
• The study highlights the need for nuanced patient stratification to identify subgroups that might benefit differently from specific treatments.
• Further research into sex-specific outcomes and other demographic factors is warranted for personalized treatment strategies.