Five-year follow-up results of the PROFHER trial comparing operative and non-operative treatment of adults with a displaced fracture of the proximal humerus
نویسندگان
چکیده
AIMS The PROximal Fracture of the Humerus Evaluation by Randomisation (PROFHER) randomised clinical trial compared the operative and non-operative treatment of adults with a displaced fracture of the proximal humerus involving the surgical neck. The aim of this study was to determine the long-term treatment effects beyond the two-year follow-up. PATIENTS AND METHODS Of the original 250 trial participants, 176 consented to extended follow-up and were sent postal questionnaires at three, four and five years after recruitment to the trial. The Oxford Shoulder Score (OSS; the primary outcome), EuroQol 5D-3L (EQ-5D-3L), and any recent shoulder operations and fracture data were collected. Statistical and economic analyses, consistent with those of the main trial were applied. RESULTS OSS data were available for 164, 155 and 149 participants at three, four and five years, respectively. There were no statistically or clinically significant differences between operative and non-operative treatment at each follow-up point. No participant had secondary shoulder surgery for a new complication. Analyses of EQ-5D-3L data showed no significant between-group differences in quality of life over time. CONCLUSION These results confirm that the main findings of the PROFHER trial over two years are unchanged at five years. Cite this article: Bone Joint J 2017;99-B:383-92.
منابع مشابه
The Comparison of Results of Treatment of Midshaft Clavicle Fracture between Operative Treatment with Plate and Non-Operative Treatment
Background: Clavicle fractures are common and usually heal without complications. In this study, we evaluated the outcomes of non-operative versus operative management of displaced fractures. Methods: In a prospective clinical trial study, sixty-five patients with displaced clavicle mid-shaft fractures were nonrandomly divided in two treatment groups. The first group underwent non-operative...
متن کاملDISPLACED- COMMINUTED INTRAARTICULAR FRACTURES OF THE ADULT DISTAL HUMERUS: FUNCTIONAL RESULTS AFTER INTERNAL FIXATION
Background: Intra-articular T- type or Y- type fractures of the distal end of the humerus are relatively rare, and consequently few surgeons will be able to attain extensive experience with the surgical treatment of these injuries. The current emphasis is on operative intervention with rigid internal fixation and early mobilization. Methods: In this prospective and retrospective study, we r...
متن کاملCost effectiveness of surgical versus non-surgical treatment of adults with displaced fractures of the proximal humerus: economic evaluation alongside the PROFHER trial.
AIMS A pragmatic multicentre randomised controlled trial (PROFHER) was conducted in United Kingdom National Health Service (NHS) hospitals to evaluate the clinical effectiveness and cost effectiveness of surgery compared with non-surgical treatment for displaced fractures of the proximal humerus involving the surgical neck in adults. METHODS A cost utility analysis from the NHS perspective wa...
متن کاملEarly Versus Late Reverse Shoulder Arthroplasty for Proximal Humerus Fractures: Does It Matter?
Background: This study compared the outcomes between patients with proximal humerus fractures (PHF) whounderwent acute reverse total shoulder arthroplasty (RSA) to those who underwent an alternative initial treatmentbefore requiring (secondary) RSA.Methods: Patients who underwent RSA after suffering a PHF were identified. Two year clinical follow-up was requiredfor inclusion. Patients were divi...
متن کاملSurgical vs nonsurgical treatment of adults with displaced fractures of the proximal humerus: the PROFHER randomized clinical trial.
IMPORTANCE The need for surgery for the majority of patients with displaced proximal humeral fractures is unclear, but its use is increasing. OBJECTIVE To evaluate the clinical effectiveness of surgical vs nonsurgical treatment for adults with displaced fractures of the proximal humerus involving the surgical neck. DESIGN, SETTING, AND PARTICIPANTS A pragmatic, multicenter, parallel-group, ...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
دوره 99-B شماره
صفحات -
تاریخ انتشار 2017