부산대학교 도서관

OBJECTIVES:: To compare Patient Reported Outcomes (PROs), Range of Motion (ROM), and complication rates for proximal humerus fractures managed nonoperatively or with open reduction internal fixation (ORIF). DESIGN:: Retrospective Cohort. SETTING:: Academic level 1 trauma center.Patients/Participants: 431 patients > 55 years old were identified retrospectively. 122 patients were excluded. 309 patients with proximal humerus fractures met inclusion criteria (234 nonoperative, 75 ORIF). After matching, 192 patients (121 nonoperative, 71 ORIF) were included in the analysis INTERVENTION:: Nonoperative versus ORIF (locked plate) treatment of proximal humerus fracture. MAIN OUTCOME MEASUREMENTS:: Early Visual Analog Score (VAS), ROM, PROs, complications, and reoperation rates between groups. RESULTS:: At 2 weeks ORIF showed lower VAS scores, better passive ROM and PROMIS scores (p<0.05) compared to non-operative treatment. At 6 weeks ORIF had lower VAS scores, better passive ROM and PROMIS scores (p<0.05) compared to nonoperative treatment. At 3 months ORIF showed similar PROMIS scores (p>0.05), but lower VAS scores and better passive ROM (p<0.05) compared to non-operative treatment. At 6 months ORIF showed similar VAS scores, ROM, and PROMIS scores(p>0.05) compared to nonoperative treatment. There was no difference in secondary operation rates between groups (P>0.05). ORIF patients trended toward a higher secondary reoperation rate (15.5% vs 5.0%) than nonoperative patients (p=0.053). CONCLUSIONS:: In an age, comorbidity, and fracture morphology matched analysis of proximal humerus fractures, ORIF led to decreased pain and improved passive ROM early in recovery curve compared to nonoperative treatment that normalized after 6 months between groups. LEVEL OF EVIDENCE:: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.