title: Outcome after operative treatment of proximal humeral fractures in elderly patients.
abstract: BACKGROUND
  The proximal humeral fracture (PHF) (5 %) of the elderly is the third most common fracture after proximal femoral and distal radius fractures. Proximal femoral fractures often lead to a loss of autonomy.
  
  
  OBJECTIVE
  The aim of this study is to show how PHF changes the patient's autonomy and the coping with everyday life as well as which factors influence the outcome 1 year (y) after surgery.
  
  
  METHODS
  Data of 62 patients with surgical treatment of a PHF ≥ 60 y was prospectively collected. With a telephone interview Short Form (SF) 12 (physical and mental health; PH, MH), Barthel Index (BI), range of motion, pain, and satisfaction was observed after 3 and 12 months. The dependence of outcome on different factors was investigated.
  
  
  RESULTS
  The mean age was 73.3 y (median 73, 60-94). Mortality after 3 months was 3 % and after 1 y 11 %. The PH before the injury (47.9) was significantly better than after 3 months (37.1) and after 1 y (42.6). The MH showed no difference. The BI before the injury (92) was significantly better than after 3 months (86), but the same after 1 y (91). After 1 y > 50 % were able to abduct and flex the arm > 90°. More than two-thirds were able to perform everyday life activities for body care and nutrition after 1 y. Approximately, 73 % of the patients had little or no pain, and 84 % were satisfied with the result after 1 y. Good score values before the fracture resulted in better outcome. Higher severity in fracture led to a higher level of pain.
  
  
  CONCLUSIONS
  A surgically treated PHF in the elderly does not lead to a relevant impairment in quality of life. Despite the lack of complete retrieval of range of motion patients achieve a good to very good result in coping with everyday life.
authors.affiliation: Department for Trauma and Orthopedic Surgery I, Westpfalz-Klinikum Kaiserslautern, Academic Educational Hospital, Heidelberg University and Mainz University, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany. mmuhm@westpfalz-klinikum.de.|Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany. mmuhm@westpfalz-klinikum.de.
authors.forename: Markus
authors.initials: M
authors.lastname: Muhm
authors.affiliation: Department for Trauma and Orthopedic Surgery, Municipal Hospital, Pirmasens, Germany.
authors.forename: Julia
authors.initials: J
authors.lastname: Bott
authors.affiliation: Department for Trauma and Orthopedic Surgery I, Westpfalz-Klinikum Kaiserslautern, Academic Educational Hospital, Heidelberg University and Mainz University, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Lahr
authors.affiliation: Department for Trauma and Orthopedic Surgery I, Westpfalz-Klinikum Kaiserslautern, Academic Educational Hospital, Heidelberg University and Mainz University, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany.|Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany.
authors.forename: Hartmut
authors.initials: H
authors.lastname: Winkler
authors.affiliation: Department for Trauma and Orthopedic Surgery I, Westpfalz-Klinikum Kaiserslautern, Academic Educational Hospital, Heidelberg University and Mainz University, Hellmut-Hartert-Str. 1, 67655, Kaiserslautern, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Ruffing
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D005260:Female; D005593:Fracture Fixation, Internal / Q000401:mortality* / Q000523:psychology / Q000534:rehabilitation; D017102:Fracture Healing; D015577:Geriatric Assessment; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000401:mortality* / Q000517:prevention & control / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life / Q000523:psychology*; D016059:Range of Motion, Articular; D012307:Risk Factors; D012784:Shoulder Fractures / Q000401:mortality* / Q000523:psychology / Q000601:surgery*; D020069:Shoulder Pain / Q000401:mortality* / Q000517:prevention & control / Q000523:psychology; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Coping with everyday life; Outcome; Proximal humeral fracture; Quality of life; Satisfaction