Displaced proximal humeral fractures: operative versus non-operative treatment--a 2-year extension of a randomized controlled trial

Abstract

Background: Surgical treatment for displaced proximal humeral fractures is widely used. However, there are very few randomized controlled studies comparing surgical treatment to conservative treatment, and the evidence is debated. The aim of this study was to describe patients with displaced proximal humeral fractures in a 2-years extension of a randomized controlled trial, their functional outcome and quality of life.

Materials and methods: Patients from a single-center randomized controlled study of fifty patients aged 60 or above with displaced proximal humeral fracture (AO/OTA group B2 or C2) were randomized to surgical or conservative treatment. Surgery was performed with an angular stable implant. The main outcome was Constant score at 2-year follow-up. Secondary outcomes were an ASES self-assessment form, the 15D quality of life assessment and radiographs at 2 years.

Results: A marked improvement of shoulder function and health-related quality of life for both surgically and conservatively treated patients occurs between 6 and 12 months. Almost no change was observed between 1 and 2 year. There were no significant differences between the two treatments at 2-year follow-up.

Conclusions: In this randomized controlled trial, surgical treatment proved no better results than conservative treatment for patients with displaced proximal humeral fracture at 2-year follow-up.