TITLE

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

AUTHOR(S)
Tao Fu; Chengyan Xia; Zonghuan Li; Hua Wu
PUB. DATE
December 2014
SOURCE
International Journal of Clinical & Experimental Medicine;2014, Vol. 7 Issue 12, p4607
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
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.
ACCESSION #
100465780

 

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