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PROFHER试验的五年随访结果:比较成人肱骨近端移位骨折的手术治疗与非手术治疗

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.

作者信息

Handoll H H, Keding A, Corbacho B, Brealey S D, Hewitt C, Rangan A

机构信息

Teesside University, Middlesbrough, Tees Valley TS1 3BA, UK.

University of York, Lower Ground Floor, ARRC Building, Heslington, York YO10 5DD, UK.

出版信息

Bone Joint J. 2017 Mar;99-B(3):383-392. doi: 10.1302/0301-620X.99B3.BJJ-2016-1028.

Abstract

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: 2017;99-B:383-92.

摘要

目的

肱骨近端骨折随机评估(PROFHER)随机临床试验比较了成人肱骨近端移位骨折累及外科颈的手术治疗与非手术治疗。本研究的目的是确定两年随访期后的长期治疗效果。

患者与方法

在最初的250名试验参与者中,176人同意延长随访,并在入选试验后的三年、四年和五年收到邮寄问卷。收集牛津肩部评分(OSS;主要结局指标)、欧洲五维健康量表(EQ-5D-3L)以及近期任何肩部手术和骨折数据。采用与主要试验一致的统计和经济分析方法。

结果

在三年、四年和五年时,分别有164、155和149名参与者获得了OSS数据。在每个随访点,手术治疗与非手术治疗之间在统计学或临床上均无显著差异。没有参与者因新的并发症接受二次肩部手术。EQ-5D-3L数据分析显示,随着时间推移,两组之间在生活质量方面无显著差异。

结论

这些结果证实,PROFHER试验两年的主要研究结果在五年时未发生变化。引用本文:2017;99-B:383-92。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f94/5404240/f82eed3d267f/BJJ-2016-1028-galleyfig1.jpg

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