No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures

No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures

Background and purpose — Clear and acknowledged treatment algorithms for proximal humeral fractures (PHFs) are lacking. Nevertheless, a change in treatment trends, including a change towards more reversed shoulder arthroplasties (RSA), has been observed during recent years. We examined the effect of...

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Autores principales: Carl Bergdahl, David Wennergren, Eleonora Swensson-Backelin, Jan Ekelund, Michael Möller
Formato: article
Lenguaje:EN
Publicado: Taylor & Francis Group 2021
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Orthopedic surgery
RD701-811
Acceso en línea:https://doaj.org/article/ddc0a8fb2d7b4d178910adbd7ac36866
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spelling oai:doaj.org-article:ddc0a8fb2d7b4d178910adbd7ac368662021-11-26T11:19:48ZNo change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures1745-36741745-368210.1080/17453674.2021.1941629https://doaj.org/article/ddc0a8fb2d7b4d178910adbd7ac368662021-10-01T00:00:00Zhttp://dx.doi.org/10.1080/17453674.2021.1941629https://doaj.org/toc/1745-3674https://doaj.org/toc/1745-3682Background and purpose — Clear and acknowledged treatment algorithms for proximal humeral fractures (PHFs) are lacking. Nevertheless, a change in treatment trends, including a change towards more reversed shoulder arthroplasties (RSA), has been observed during recent years. We examined the effect of these changes on reoperation rates. Patients and methods — Between 2011 and 2017, 4,070 PHFs treated at Sahlgrenska University Hospital were registered prospectively in the Swedish Fracture Register (SFR) and followed up until 2019 (mean follow-up of 4.5 years). Data on all reoperations were gathered from the SFR and from medical records. Results — The majority of PHFs were treated non-surgically and the proportion increased slightly, but not statistically significantly, during the study period (from 76% to 79%). Of the surgically treated fractures, the proportion fixed with a plate decreased from 47% to 25%, while the use of RSA increased 9-fold (from 2.0% to 19%). 221 patients underwent 302 reoperations. For those primarily treated surgically, the reoperation rate was 17%. Among treatment modalities, plate fixation was associated with the highest reoperation rate (21%). Rate of reoperations remained constant during the study period, both for the entire study cohort and for the surgically treated patients Interpretation — During the study period, treatment changes that are in accordance with recently published treatment recommendations were observed. However, these treatment changes did not affect the reoperation rate. Treatment with a plate, intramedullary nail, or hemiarthroplasty was associated with the highest reoperation rates. The fact that almost every 4th surgical procedure was a reoperation indicates a need for further improvement of modern treatment concepts for PHFs.Carl BergdahlDavid WennergrenEleonora Swensson-BackelinJan EkelundMichael MöllerTaylor & Francis GrouparticleOrthopedic surgeryRD701-811ENActa Orthopaedica, Vol 92, Iss 6, Pp 651-657 (2021)
institution DOAJ
collection DOAJ
language EN
topic Orthopedic surgery
RD701-811
spellingShingle Orthopedic surgery
RD701-811
Carl Bergdahl
David Wennergren
Eleonora Swensson-Backelin
Jan Ekelund
Michael Möller
No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
description Background and purpose — Clear and acknowledged treatment algorithms for proximal humeral fractures (PHFs) are lacking. Nevertheless, a change in treatment trends, including a change towards more reversed shoulder arthroplasties (RSA), has been observed during recent years. We examined the effect of these changes on reoperation rates. Patients and methods — Between 2011 and 2017, 4,070 PHFs treated at Sahlgrenska University Hospital were registered prospectively in the Swedish Fracture Register (SFR) and followed up until 2019 (mean follow-up of 4.5 years). Data on all reoperations were gathered from the SFR and from medical records. Results — The majority of PHFs were treated non-surgically and the proportion increased slightly, but not statistically significantly, during the study period (from 76% to 79%). Of the surgically treated fractures, the proportion fixed with a plate decreased from 47% to 25%, while the use of RSA increased 9-fold (from 2.0% to 19%). 221 patients underwent 302 reoperations. For those primarily treated surgically, the reoperation rate was 17%. Among treatment modalities, plate fixation was associated with the highest reoperation rate (21%). Rate of reoperations remained constant during the study period, both for the entire study cohort and for the surgically treated patients Interpretation — During the study period, treatment changes that are in accordance with recently published treatment recommendations were observed. However, these treatment changes did not affect the reoperation rate. Treatment with a plate, intramedullary nail, or hemiarthroplasty was associated with the highest reoperation rates. The fact that almost every 4th surgical procedure was a reoperation indicates a need for further improvement of modern treatment concepts for PHFs.
format article
author Carl Bergdahl
David Wennergren
Eleonora Swensson-Backelin
Jan Ekelund
Michael Möller
author_facet Carl Bergdahl
David Wennergren
Eleonora Swensson-Backelin
Jan Ekelund
Michael Möller
author_sort Carl Bergdahl
title No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
title_short No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
title_full No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
title_fullStr No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
title_full_unstemmed No change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
title_sort no change in reoperation rates despite shifting treatment trends: a population-based study of 4,070 proximal humeral fractures
publisher Taylor & Francis Group
publishDate 2021
url https://doaj.org/article/ddc0a8fb2d7b4d178910adbd7ac36866
work_keys_str_mv AT carlbergdahl nochangeinreoperationratesdespiteshiftingtreatmenttrendsapopulationbasedstudyof4070proximalhumeralfractures
AT davidwennergren nochangeinreoperationratesdespiteshiftingtreatmenttrendsapopulationbasedstudyof4070proximalhumeralfractures
AT eleonoraswenssonbackelin nochangeinreoperationratesdespiteshiftingtreatmenttrendsapopulationbasedstudyof4070proximalhumeralfractures
AT janekelund nochangeinreoperationratesdespiteshiftingtreatmenttrendsapopulationbasedstudyof4070proximalhumeralfractures
AT michaelmoller nochangeinreoperationratesdespiteshiftingtreatmenttrendsapopulationbasedstudyof4070proximalhumeralfractures
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