Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University

Treating Shoulder Fracture with a Sling, Not Surgery

MedicalResearch.com Interview with:

Prof. Inger Mechlenburg, PhD, DMSc Orthopaedic Department, Aarhus University Hospital Department of Clinical Medicine Aarhus University

Prof. Mechlenburg

Prof. Inger Mechlenburg, PhD, DMSc
Orthopaedic Department, Aarhus University Hospital
Department of Clinical Medicine
Aarhus University

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Traditionally, displaced 2-part humerus fractures have been operatively treated using a metal plate and screws. However, there are no studies showing a benefit of operation of those fractures. Therefore, we were interested in investigating, in a direct comparison between operation and non-operative treatment, whether there was a difference in patient-reported function, pain and health-related quality of life two years after the fracture.

In this Nordic research collaboration http://nitep.eu/en/ between Finland, Sweden, Estonia and Denmark we showed that there is no difference in functional results between operative and non-operative treatment in persons aged 60 or more with displaced proximal humerus fractures.

In the study, only fractures with a significant displacement between bone fragments were included. In the non-operative treatment group, patients used a collar and cuff sling for three weeks and underwent instructed physiotherapy.

MedicalResearch.com: What should readers take away from your report?

Response: There is nothing to be gained by operating on a patient with a displaced 2-part fracture of the shoulder. Three weeks with the arm in a sling so that the shoulder is kept inactive yields the same results. This is now documented. The findings of the study are novel and challenge current treatment protocols.

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: The next object for our research group is to assess whether older adults with 3- or 4-part proximal humerus fractures will benefit from surgery. Furthermore, health economic studies should assess the savings by abandoning those procedures that offer no benefit to the patient.   

No disclosures. 

Citation:

Operative versus non-operative treatment for 2-part proximal humerus fracture: A multicenter rdomized controlled trial

Antti P. Launonen , Bakir O. Sumrein, Aleksi Reito, Vesa Lepola, Juha Paloneva, Kenneth B. Jonsson, Olof Wolf, Peter Ström, Hans E. Berg, Li Felländer-Tsai, Karl-Åke Jansson, Daniel Fell, Inger Mechlenburg, as the NITEP group
Published: July 18, 2019

https://doi.org/10.1371/journal.pmed.1002855

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Aug 12, 2019 @ 1:51 pm

 

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