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. 2019 Mar 30;20(1):136.
doi: 10.1186/s12891-019-2515-2.

Surgical trends in elderly patients with proximal humeral fractures in South Korea: a population-based study

Young-Hoon Jo  1 , Kwang-Hyun Lee  2 , Bong-Gun Lee  3
Affiliations

Surgical trends in elderly patients with proximal humeral fractures in South Korea: a population-based study

Young-Hoon Jo et al. BMC Musculoskelet Disord. .

Abstract

Background: It is known that there are large regional variations in treatment methods for the management of proximal humeral fractures. The objective of this study was to investigate the national surgical trends in elderly patients with proximal humeral fractures in South Korea.

Methods: We analyzed the Korean Health Insurance Review and Assessment Service database from 2008 to 2016. International Classification of Diseases, 10th revision codes and procedure codes were used to identify patients aged ≥65 years with proximal humeral fractures.

Results: A total of 69,120 proximal humeral fractures were identified from 2008 to 2016. The overall operative rate for proximal humeral fractures increased steadily from 24.6% in 2008 to 36.8% in 2016 (p < 0.001). The rate of cases treated with open reduction and internal fixation tended to increase each year, from 71.5% of the overall surgeries in 2008 to 85.6% in 2016; conversely, the rate of cases treated with closed reduction and internal fixation tended to decrease from 19.9% in 2008 to 4.5% in 2016. In terms of type of arthroplasty procedure, the rate of cases treated with reverse shoulder arthroplasty tended to increase significantly each year, from 8.2% of the overall arthroplasty procedures in 2008 to 52.0% in 2016 (p < 0.001). The proportion of reverse shoulder arthroplasty was shown to increase especially in patients aged 80 years or older.

Conclusion: Overall, our findings indicated that surgical treatment of proximal humeral fractures, particularly by open reduction and internal fixation, continues to increase; in terms of type of arthroplasty procedure, the rate of cases treated with reverse shoulder arthroplasty tended to increase.

Keywords: Epidemiology; Proximal humeral fracture; Surgery; Trend.

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Conflict of interest statement

Ethics approval and consent to participate

This study protocol was exempted for review by the institutional review board of the Hanyang University Hospital (HYUH 2017–08-023) in accordance with the exemption criteria. Informed consent was exempted because this study used only data opened to the public. The plain radiographs demonstrating types of surgical treatment of proximal humeral fractures were included in Fig. 1 after receiving written informed consent from the patients.

Consent for publication

Consent was obtained from patients whose images are presented in Fig. 1.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Plain radiographs demonstrating types of surgical treatment of proximal humeral fractures: (a) open reduction and internal fixation (b) closed reduction and internal fixation (c) hemiarthroplasty (d) reverse shoulder arthroplasty. All surgeries took place at Hanyang University Medical Centre, and patients gave informed consent for the publication of their radiographs
Fig. 2
Fig. 2
Proportions of surgical treatment in patients ≥65 years of age with proximal humeral fractures, by year. The values are percentage values
Fig. 3
Fig. 3
Proportions of operation type in patients ≥65 years of age with proximal humeral fractures, by year. The values are percentage values
Fig. 4
Fig. 4
The ratios of reverse shoulder arthroplasty and hemiarthroplasty in patients ≥65 years of age who underwent arthroplasty procedures for PHFs, by year. The values are percentage values
See this image and copyright information in PMC

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