title: Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients.
abstract: OBJECTIVE
  This study aims to evaluate the costs and health outcome for surgical and conservative treatment of displaced proximal humeral fractures.
  
  
  METHODS
  This study is a randomised controlled trial.
  
  
  METHODS
  This study included 50 patients aged 60 or older admitted to hospital with a severely displaced three- or four-part fracture.
  
  
  METHODS
  The patients were treated surgically with an angular stable interlocking implant (25 patients) or conservative treatment (25 patients).
  
  
  METHODS
  The outcomes measured included quality-adjusted life years (QALYs) and societal costs.
  
  
  RESULTS
  At 12 months' follow-up, the mean difference in the number of QALYs was 0.027 (95% confidence interval (CI)=-0.025, 0.078) while the mean difference in total health-care costs was 597 euro in favour of surgery (95% CI=-5291, 3777).
  
  
  CONCLUSIONS
  There was no significant difference in QALYs or costs between surgical and conservative treatment of severe displaced proximal humeral fractures.
authors: Orthopaedic Department, Oslo University Hospital Aker, Norway. torfja@online.no
authors: T
authors: T
authors: Fjalestad
authors: M Ø
authors: MØ
authors: Hole
authors: J J
authors: JJ
authors: Jørgensen
authors: K
authors: K
authors: Strømsøe
authors: I S
authors: IS
authors: Kristiansen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017281:Cost of Illness; D005260:Female; D005592:Fracture Fixation / Q000191:economics / Q000379:methods*; D017048:Health Care Costs; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care; D019057:Quality-Adjusted Life Years; D012784:Shoulder Fractures / Q000191:economics / Q000601:surgery / Q000628:therapy*; D013997:Time Factors