Surgical versus conservative treatment for displaced proximal humeral fractures in elderly patients: a meta-analysis

Tao Fu; Chengyan Xia; Zonghuan Li; Hua Wu
December 2014
International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 12, p4607
Academic Journal
Purpose: Treatment strategies for complex displaced proximal humeral fractures (DPHF) in elderly patients remain controversial. This meta-analysis was performed to compare the benefits and risks of surgical or conservative methods for these patients. Methods: Pubmed, Cochrane library and EMBASE were systematically searched for randomized controlled trials (RCTs) from their establishment to June 2013. Researches on surgical/conservative treatment for complex displaced proximal humeral fractures in elderly patients were selected. Methodological quality of included studies was evaluated by the Physiotherapy Evidence Database (PEDro) scale. Outcome measurements were Constant score, DASH (disabilities of the arm, shoulder and hand), postoperative complications and quality of life (QoL). The meta-analysis was performed with software Stata 12.0. Results: Six RCTs with 272 patients were included and analyzed. Fix studies with a PEDro score of 6 or more were of high quality. The differences in QoL (WMD 0.43, 95% CI (0.12, 0.74)) and postoperative complications (RR 2.06, 95% CI (1.45, 2.93)) were statisti cally significant between operative and conservative treatment. There was no statistically significant difference in Constant score (WMD 0.06, 95% CI (-0.20, 0.31)) and DASH (WMD 0.33, 95% CI (-0.70, 0.04)). Conclusion: Despite the small improvement of QoL, surgical treatments did not significantly improve the functional outcome including Constant score and DASH. Instead, surgical treatment for displaced proximal humeral fractures in elderly patients led to higher incidence of postoperative complications.


Related Articles

  • Enhanced Recovery Program in Colorectal Surgery: A Meta-analysis of Randomized Controlled Trials. Greco, Massimiliano; Capretti, Giovanni; Beretta, Luigi; Gemma, Marco; Pecorelli, Nicolò; Braga, Marco // World Journal of Surgery;Jun2014, Vol. 38 Issue 6, p1531 

    Background: Meta-analyses in the literature show that enhanced recovery after surgery (ERAS) is associated with lower morbidity rate and shorter hospital stay after elective colorectal surgery. However, a recent Cochrane review did not indicate the ERAS pathway as being the new standard of care...

  • Gum chewing as a strategy to reduce the duration of postoperative ileus. Lafon, Caroline; Lawson, Lauren // Gastrointestinal Nursing;Apr2012, Vol. 10 Issue 3, p17 

    Postoperative ileus is a common complication following surgery. Many pharmacological agents and surgical techniques have been proposed to influence the severity and duration of an ileus; however, no individual method has been shown to successfully influence its clinical course. Often, these...

  • Operative Treatment of Dislocated Midshaft Clavicular Fractures: Plate or Intramedullary Nail Fixation? Van der Meijden, Olivier A.; Marijn Houwert, R.; Hulsmans, Martijn; Wijdicks, Frans-Jasper G.; Dijkgraaf, Marcel G. W.; Meylaerts, Sven A. G.; Hammacher, Eric R.; Verhofstad, Michiel H. J.; Verleisdonk, Egbert J. M. M. // Journal of Bone & Joint Surgery, American Volume;4/15/2015, Vol. 97 Issue 8, p613 

    Background: Over the past decades, the operative treatment of displaced midshaft clavicular fractures has increased. The aim of this study was to compare short and midterm results of open reduction and plate fixation with those of intramedullary nailing for displaced midshaft clavicular...

  • Weight-Bearing and Mobilization in the Postoperative Care of Ankle Fractures: A Systematic Review and Meta-Analysis of Randomized Controlled Trials and Cohort Studies. Smeeing, Diederik P. J.; Houwert, Roderick M.; Briet, Jan Paul; Kelder, Johannes C.; Segers, Michiel J. M.; Verleisdonk, Egbert Jan M. M.; Leenen, Luke P. H.; Hietbrink, Falco // PLoS ONE;Feb2015, Vol. 10 Issue 2, p1 

    Purpose: To determine the effectiveness and safety of interventions used for rehabilitation after open reduction and internal fixation of ankle fractures. Methods: A systematic review and meta-analysis was performed using both randomized trials and cohort studies. The effect of mobilization,...

  • Clonidine versus other adjuncts added to local anesthetics for pediatric neuraxial blocks: a systematic review and meta-analysis. Yang, Yang; Yu, Ling-Yu; Zhang, Wen-Sheng // Journal of Pain Research;May2018, Vol. 11, p1027 

    Background: Clonidine is a common adjunct to local anesthetics for pediatric neuraxial block; however, the pros and cons between clonidine and other adjuncts remain unclear. Thus, we performed this meta-analysis of randomized controlled trials to assess the efficacy and adverse effects between...

  • Effect of Gum Chewing on Prevention of Post Cesarean Ileus. Akhlaghi, F.; Pourjavad, M.; Mansouri, A.; Tara, F.; Vahedian, M. // HAYAT;2008, Vol. 14 Issue 2, p84 

    Background & Aim: Post cesarean ileus is a common complication that induces abdominal distention, delays feeding, and increases hospitalization. Multiple studies showed that false nutrition increases the bowel movement. This study aimed to investigate the effect of gum chewing as false nutrition...

  • Comparison of clinical effects between warm water spray and sitz bath in post-hemorrhoidectomy period. Kuo-Feng Hsu; Jen-Shu Chia; Shu-Wen Jao; Chang-Chieh Wu; Hsiang-Yu Yang; Chen-Ming Mai; Chun-Yu Fu; Cheng-Wen Hsiao; Hsu, Kuo-Feng; Chia, Jen-Shu; Jao, Shu-Wen; Wu, Chang-Chieh; Yang, Hsiang-Yu; Mai, Chen-Ming; Fu, Chun-Yu; Hsiao, Cheng-Wen // Journal of Gastrointestinal Surgery;Jul2009, Vol. 13 Issue 7, p1274 

    Background: Warm water sitz bath is advised for a variety of anorectal disorders. However, preparation of the sitz bath is sometimes difficult for patients. As an alternative to the sitz bath, we have adapted a water spray method. A randomized, controlled study was conducted to...

  • Clinical comparison and short-term radiographic evaluation of Tight Rope and Lateral Suture procedures for dogs after cranial cruciate ligament rupture. LEDECKY, V.; HLUCHY, M.; FREILICHMAN, R.; HORNAK, S.; KNAZOVICKY, D. // Veterinární Medicína;2014, Vol. 59 Issue 10, p502 

    The aim of this study was to monitor short-term osteoarthrosis progress in relation to a recently introduced novel extracapsular method called the Tight Rope procedure and after Lateral Suture with nylon in cruciate-deficient dog stifle joints. Twelve dogs were included in the study. Treatment...

  • Periarticular multimodal drug injection in total knee arthroplasty. Teng, Yuanjun; Jiang, Jin; Chen, Shaolong; Zhao, Lianggong; Cui, Zhaohui; Khan, Md; Du, Wenjia; Gao, Xuren; Wang, Jing; Xia, Yayi // Knee Surgery, Sports Traumatology, Arthroscopy;Aug2014, Vol. 22 Issue 8, p1949 

    Purpose: A systematic review and meta-analysis based on randomized controlled trials (RCTs) were conducted to evaluate the efficiency and safety of periarticular multimodal drug injection in total knee arthroplasty (TKA). Methods: Periarticular injection with the use of multimodal drugs is an...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics