title: The outcome of proximal humeral fractures in the elderly: predictors of mortality and function.
abstract: This study describes the epidemiology and outcome of 637 proximal humeral fractures in 629 elderly (≥ 65 years old) patients. Most were either minimally displaced (n = 278, 44%) or two-part fractures (n = 250, 39%) that predominantly occurred in women (n = 525, 82%) after a simple fall (n = 604, 95%), who lived independently in their own home (n = 560, 88%), and one in ten sustained a concomitant fracture (n = 76, 11.9%). The rate of mortality at one year was 10%, with the only independent predictor of survival being whether the patient lived in their own home (p = 0.025). Many factors associated with the patient's social independence significantly influenced the age and gender adjusted Constant score one year after the fracture. More than a quarter of the patients had a poor functional outcome, with those patients not living in their own home (p = 0.04), participating in recreational activities (p = 0.01), able to perform their own shopping (p < 0.001), or able to dress themselves (p = 0.02) being at a significantly increased risk of a poor outcome, which was independent of the severity of the fracture (p = 0.001). A poor functional outcome after a proximal humeral fracture is not independently influenced by age in the elderly, and factors associated with social independence are more predictive of outcome.
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh Orthopaedic Trauma Unit, 51 Little France Crescent, Edinburgh, EH16 4SU, UK.
authors.forename: N D
authors.initials: ND
authors.lastname: Clement
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh Orthopaedic Trauma Unit, 51 Little France Crescent, Edinburgh, EH16 4SU, UK.
authors.forename: A D
authors.initials: AD
authors.lastname: Duckworth
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh Orthopaedic Trauma Unit, 51 Little France Crescent, Edinburgh, EH16 4SU, UK.
authors.forename: M M
authors.initials: MM
authors.lastname: McQueen
authors.affiliation: Royal Infirmary of Edinburgh, Edinburgh Orthopaedic Trauma Unit, 51 Little France Crescent, Edinburgh, EH16 4SU, UK.
authors.forename: C M
authors.initials: CM
authors.lastname: Court-Brown
mesh_terms: D000058:Accidental Falls / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D020127:Recovery of Function; D012189:Retrospective Studies; D012782:Shoulder / Q000503:physiopathology*; D012784:Shoulder Fractures / Q000453:epidemiology / Q000401:mortality* / Q000503:physiopathology / Q000601:surgery*
keywords: Constant score; Fracture; elderly; mortality; outcome; proximal humerus