Health and cost consequences of surgical versus conservative treatment for a comminuted proximal humeral fracture in elderly patients.
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.
Fjalestad
T
T
Orthopaedic Department, Oslo University Hospital Aker, Norway. torfja@online.no
Hole
M Ø
MØ
Jørgensen
J J
JJ
Strømsøe
K
K
Kristiansen
I S
IS
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