title: Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus.
abstract: OBJECTIVE
  The PROximal Fracture of the Humerus Evaluation by Randomisation (PROFHER) randomised clinical trial compared the operative and non-operative treatment of adults with a displaced fracture of the proximal humerus involving the surgical neck. The aim of this study was to determine the long-term treatment effects beyond the two-year follow-up.
  
  
  METHODS
  Of the original 250 trial participants, 176 consented to extended follow-up and were sent postal questionnaires at three, four and five years after recruitment to the trial. The Oxford Shoulder Score (OSS; the primary outcome), EuroQol 5D-3L (EQ-5D-3L), and any recent shoulder operations and fracture data were collected. Statistical and economic analyses, consistent with those of the main trial were applied.
  
  
  RESULTS
  OSS data were available for 164, 155 and 149 participants at three, four and five years, respectively. There were no statistically or clinically significant differences between operative and non-operative treatment at each follow-up point. No participant had secondary shoulder surgery for a new complication. Analyses of EQ-5D-3L data showed no significant between-group differences in quality of life over time.
  
  
  CONCLUSIONS
  These results confirm that the main findings of the PROFHER trial over two years are unchanged at five years. Cite this article:Bone Joint J2017;99-B:383-92.
authors.affiliation: Teesside University, Middlesbrough, Tees Valley TS1 3BA, UK.
authors.forename: H H
authors.initials: HH
authors.lastname: Handoll
authors.affiliation: University of York, Lower Ground Floor, ARRC Building, Heslington, York YO10 5DD, UK.
authors.forename: A
authors.initials: A
authors.lastname: Keding
authors.affiliation: University of York, Lower Ground Floor, ARRC Building, Heslington, York YO10 5DD, UK.
authors.forename: B
authors.initials: B
authors.lastname: Corbacho
authors.affiliation: University of York, Lower Ground Floor, ARRC Building, Heslington, York YO10 5DD, UK.
authors.forename: S D
authors.initials: SD
authors.lastname: Brealey
authors.affiliation: University of York, Lower Ground Floor, ARRC Building, Heslington, York YO10 5DD, UK.
authors.forename: C
authors.initials: C
authors.lastname: Hewitt
authors.affiliation: James Cook University Hospital, South Tees Hospitals NHS Trust, Marton Road, Middlesbrough TS4 3BW, UK.
authors.forename: A
authors.initials: A
authors.lastname: Rangan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D020127:Recovery of Function; D012784:Shoulder Fractures / Q000601:surgery / Q000628:therapy*; D012785:Shoulder Joint / Q000503:physiopathology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Long-term follow-up; Operative versus non-operative treatment; Proximal humeral fractures; Randomised controlled trial