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Sling, PT May Be OK for Two-Part Proximal Humerus Fractures

Findings in older adults counter current preference for surgical treatment of this type of fracture

elderly man wearing sling

FRIDAY, July 26, 2019 (HealthDay News) -- Functional results may be the same for operative and nonoperative treatment of displaced two-part proximal humerus fractures in patients over 60 years of age, according to a study published online July 18 in PLOS Medicine.

Antti P. Launonen, M.D., Ph.D., from University of Tampere in Finland, and colleagues randomly assigned 88 patients (aged ≥60 years) with displaced (>1 cm or 45 degrees) two-part surgical or anatomical neck proximal humerus fracture to either operative treatment with a locking plate or nonoperative treatment (a collar-cuff sling for three weeks and instructed physical therapy) between February 2011 and April 2016.

The researchers found that the mean Disabilities of Arm, Shoulder, and Hand (DASH) score (0 best, 100 worst) at two years was 18.5 points for the operative treatment group and 17.4 points for the nonoperative group (mean difference, 1.1; 95 percent confidence interval, −7.8 to 9.4; P = 0.81). There were no statistically or clinically significant between-group differences at two years of follow-up in any of the outcome measures.

"These results suggest that the current practice of performing surgery on the majority of displaced proximal two-part fractures of the humerus in older adults may not be beneficial," the authors write.

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