Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz

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Gewählte Publikation:

Jafarpour, P.
The prevalence of secondary complications in proximal humeral fractures after conservative and surgical management in elderly patients.
Humanmedizin; [ Diplomarbeit ] Graz Medical University; 2020. pp. 50 [OPEN ACCESS]


Autor*innen der Med Uni Graz:
Fischerauer Stefan Franz
Puchwein Paul

Introduction: The incidence of proximal humeral fractures (PHF) is rising constantly; with PHF representing almost 5% of all fractures. About 80% of the PHF occur in patients with an age above 60 years and women are affected two to three times more often than men. Although 80% of the fractures are either slightly dislocated or not dislocated. Our aim was to investigate the prevalence of secondary complications and unplanned surgeries in patients with PHF with regards to the treatment method (operative vs. non-operative) and comorbidities. Material and Methods: A retrospective cohort study was performed at level I trauma center. The study included 156 elderly patients (mean age 77 ± 8.9 years; 75% female) with PHF [AO: A (54,5%), B (23.7%), C (21.8%)] during a 2-year period, who received either surgical (n = 28) or conservative treatment (n = 128) during a 2-year period. The primary outcome was the prevalence of secondary complications and unplanned surgeries. Secondary outcome included the association with demographic-, fracture-type-associated, or treatment-specific variables. Results: A total of 36 secondary complications (23.1%) and eight unplanned surgeries (5.1%) were accounted. There was no significant difference in the distribution of secondary complications with regard to the chosen treatment [operative (n = 5; 18%) vs. non-operative (n = 31; 24%); p = 0.620]. We noted an independent tendential risk-increase for complications in patients with osteoporosis [OR 2.119; 95% CI 0.958 – 4.687; p = 0.064] and a relative risk-reduction of unplanned surgeries in elderly patients [OR 0.885; 95% CI 0.788 – 0.993; p = 0.037]. Conclusion: The operative group yielded similar prevalence of secondary complication rates compared to the non-operative group. While osteoporosis increases the prevalence of secondary complications, complications in younger patients are more often treated by surgical procedures.

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