Operative versus non-operative treatment for 2-part proximal humerus fracture: A multicenter randomized controlled trial

↓ Direkt till sidans innehåll
↓ Direkt till sidans sekundära innehåll (sidomenyn)

Search: onr:"swepub:oai:DiVA.org:uu-393140" > Operative versus no...

1 of 1
Previous record
Next record
To hitlist

Operative versus non-operative treatment for 2-part proximal humerus fracture : A multicenter randomized controlled trial

Launonen, Antti P. (author): Univ Tampere, Fac Med & Hlth Technol, Tampere, Finland;Tampere Univ Hosp, Tampere, Finland

Sumrein, Bakir O. (author): Univ Tampere, Fac Med & Hlth Technol, Tampere, Finland;Tampere Univ Hosp, Tampere, Finland

Reito, Aleksi (author): Cent Finland Cent Hosp, Dept Orthopaed, Jyvaskyla, Finland

Lepola, Vesa (author): Univ Tampere, Fac Med & Hlth Technol, Tampere, Finland;Tampere Univ Hosp, Tampere, Finland

Paloneva, Juha (author): Cent Finland Cent Hosp, Dept Orthopaed, Jyvaskyla, Finland

Jonsson, Kenneth B (author): Uppsala universitet,Ortopedi

Wolf, Olof (author): Uppsala universitet,Ortopedi

Ström, Peter (author): Uppsala universitet,Ortopedi

Berg, Hans E. (author): Karolinska Institutet

Fellander-Tsai, Li (author): Karolinska Institutet

Jansson, Karl-Ake (author): Karolinska Institutet

Fell, Daniel (author): Karolinska Inst, Div Orthoped & Biotechnol, Dept Clin Sci Intervent & Technol, Stockholm, Sweden;Karolinska Univ Hosp, Dept Orthoped, Huddinge, Sweden

Mechlenburg, Inger (author): Aarhus Univ Hosp, Dept Orthopaed Surg, Aarhus, Denmark;Aarhus Univ, Dept Clin Med, Aarhus, Denmark

Dossing, Kaj (author): Viborg Reg Hosp, Orthoped Dept, Viborg, Denmark

Ostergaard, Helle (author): Viborg Reg Hosp, Orthoped Dept, Viborg, Denmark

Martson, Aare (author): Tartu Univ Hosp, Dept Traumatol & Orthoped, Tartu, Estonia;Tartu Univ, Tartu, Estonia

Laitinen, Minna K. (author): Univ Tampere, Fac Med & Hlth Technol, Tampere, Finland;Tampere Univ Hosp, Tampere, Finland

Mattila, Ville M. (author): Univ Tampere, Fac Med & Hlth Technol, Tampere, Finland;Tampere Univ Hosp, Tampere, Finland

show less...

(creator_code:org_t)

2019-07-18
2019
English.
In: PLoS Medicine. - : Public Library of Science (PLoS). - 1549-1277 .- 1549-1676. ; 16:7

Related links:: https://doi.org/10.1...; show more...; https://uu.diva-port... (primary) (Raw object); https://journals.plo...; https://urn.kb.se/re...; https://doi.org/10.1...; http://kipublication...; show less...

Journal article (peer-reviewed)

Abstract Subject headings

BackgroundAlthough increasingly used, the benefit of surgical treatment of displaced 2-part proximal humerus fractures has not been proven. This trial evaluates the clinical effectiveness of surgery with locking plate compared with non-operative treatment for these fractures.Methods and findingsThe NITEP group conducted a superiority, assessor-blinded, multicenter randomized trial in 6 hospitals in Finland, Estonia, Sweden, and Denmark. Eighty-eight patients aged 60 years or older with displaced (more than 1 cm or 45 degrees) 2-part surgical or anatomical neck proximal humerus fracture were randomly assigned in a 1:1 ratio to undergo either operative treatment with a locking plate or non-operative treatment. The mean age of patients was 72 years in the non-operative group and 73 years in the operative group, with a female sex distribution of 95% and 87%, respectively. Patients were recruited between February 2011 and April 2016. The primary outcome measure was Disabilities of Arm, Shoulder, and Hand (DASH) score at 2-year follow-up. Secondary outcomes included Constant–Murley score, the visual analogue scale for pain, the quality of life questionnaire 15D, EuroQol Group’s 5-dimension self-reported questionnaire EQ-5D, the Oxford Shoulder Score, and complications. The mean DASH score (0 best, 100 worst) at 2 years was 18.5 points for the operative treatment group and 17.4 points for the non-operative group (mean difference 1.1 [95% CI −7.8 to 9.4], p = 0.81). At 2 years, there were no statistically or clinically significant between-group differences in any of the outcome measures. All 3 complications resulting in secondary surgery occurred in the operative group. The lack of blinding in patient-reported outcome assessment is a limitation of the study. Our assessor physiotherapists were, however, blinded.ConclusionsThis trial found no significant difference in clinical outcomes at 2 years between surgery and non-operative treatment in patients 60 years of age or older with displaced 2-part fractures of the proximal humerus. These results suggest that the current practice of performing surgery on the majority of displaced proximal 2-part fractures of the humerus in older adults may not be beneficial.

Subject headings

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Ortopedi (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Orthopaedics (hsv//eng)

Publication and Content Type

ref (subject category)
art (subject category)

Find in a library

PLoS Medicine (Search for host publication in LIBRIS)

To the university's database

1 of 1
Previous record
Next record
To hitlist

Find more in SwePub

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Orthopaedics

Articles in the publication: PLoS Medicine

By the university: Uppsala University; Karolinska Institutet

Search outside SwePub

Extend your search to:: Google; Google Book Search; Google Scholar

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

LIBRIS.kb.se