12 Aug 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
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.
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
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