Kim, Laura (2020) Patient-reported and clinical outcomes after a proximal humerus fracture: a systematic review and retrospective cohort study. thesis, Medicine.
Full text available on request.Abstract
Retrospective cohort study Background: The literature is inconclusive regarding the superior treatment for complex proximal humerus fractures (PHFs). The aim of this retrospective cohort study was to identify risk factors for complications and reinterventions following plate osteosynthesis treatment of patients with PHFs. Methods: The cohort study included 50 patients treated between 2009 and 2018 in the University Medical Center Groningen. Mean age at trauma was 57 years, with 23 two-part, 21 three-part and five four-part PHFs. Results: This study showed a complication rate of 44% and re-intervention rate of 30%. A significant association between complications and reinterventions was found (P < 0.001, OR: 20.3, 95% CI: 3.8 – 109.9), indicating that the odds of having a reinterventions was 20.3 times higher for patients who had a complication following PHF osteosynthesis treatment. No other significant risk factors could be identified. Conclusion: Plate osteosynthesis treatment should be carefully considered as PHF option, due to the high complication and reintervention rate. Systematic review Background: An overview about how elderly patients in general are recovering after a proximal humerus fracture (PHF) is lacking in literature. Therefore, the aim of this systematic review was to provide a representative overview of the physical functioning and quality of life of elderly with a three- or four-part PHFs measured with patient-reported outcome (PROMs). Method: The OVID-Embase and MEDLINE-PubMed databases were searched between January 2010 to March 2020. The McMaster tool was used for methodological quality assessment of the included articles and a best-evidence synthesis was conducted. Results: In total 3097 patients were included from 62 full-text articles, with a moderate overall methodological quality. Thirteen different PROMs were used, of which the Constant-Murley Score (CMS) and EQ-5D were most frequently used. Mean scores respectively ranged from 37 - 82 (CMS) and 0.63 to 0.92 (EQ-5D). Conclusion: There is strong evidence that physical functioning is increasingly recovering up to 24 months post-injury. However, quality of life will likely not increase over time.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Wendt, MD PhD, K.W. and Reininga, PhD, I.H.F. |
| Faculty: | Medical Sciences |
| Date Deposited: | 11 Dec 2023 13:27 |
| Last Modified: | 11 Dec 2023 13:27 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3731 |
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